CPT code 38243: Cell boost, after transplant2026 Medicare rate & RVUs in Wisconsin

In Wisconsin, Medicare pays $97.15 for 38243 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 38243 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 38243 covers

A hematopoietic progenitor cell boost delivers additional blood-forming cells after an earlier transplant when engraftment has failed, the disease has relapsed hematologically, or the graft has been rejected. The transplant physician or hematologist typically performs the infusion in a hospital setting. This service is distinct from the original allogeneic or autologous transplant and from an infusion of donor lymphocytes, which is not a hematopoietic cell boost.

Report 38243 for the boost itself, supported by documentation of the prior transplant, the clinical indication, and the infused hematopoietic cell product. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment does not apply. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Wisconsin compares for 38243

Across 109 of 109 payment localities, the facility rate for 38243 runs from $95.41 in Arkansas to $135.96 in Alaska. Wisconsin pays $97.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

38243 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 38243 in every payment locality

How the 38243 rate is calculated

Each of 38243’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 38243

The CMS indicators that decide how 38243 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 38243

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 38243 has changed in Wisconsin

Price 38243 for an earlier date of service

Where the Wisconsin rate applies

Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.

• Abbotsford
• Abrams
• Adams
• Adell
• Albany
• Algoma
• Allens Grove
• Allenton

Browse all communities in Wisconsin

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates