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CPT code 38242: Lymphocyte infusion2026 Medicare rate & RVUs

Reports infusion of donor lymphocytes into a transplant recipient, commonly after allogeneic stem cell transplantation to support a graft-versus-tumor response.

CMS RVU26DEffective Oct 1, 2026109 payment localities240 Medicare services in 2024

Medicare pays $105.88 for 38242 nationally in a facility.

Medicare rate · 38242

Lymphocyte infusion

Office or facility?

Work RVUs
2.06
Total RVUs
3.17
Global days
000

National rate · 2026

$105.88

Facility setting, before claim adjustments.

See every locality for 38242 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 38242 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 38242 covers

This service covers infusing lymphocytes from an allogeneic donor into a recipient, commonly as donor lymphocyte infusion after an allogeneic hematopoietic cell transplant. A transplant hematologist or other physician managing cellular therapy typically directs the service in a hospital or transplant center. The clinical goal may include strengthening a graft-versus-tumor response, such as when disease persists or returns after transplant.

Choose this code for the lymphocyte infusion itself, not for a full hematopoietic cell transplant or a progenitor-cell boost. Documentation should identify the recipient, donor source, infused cell product, date, and clinical indication. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. 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.

Where 38242 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

38242 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$99.80
AlaskaUnavailable$140.29
ArizonaUnavailable$104.20
ArkansasUnavailable$99.04
Atlanta, GAUnavailable$107.55
Austin, TXUnavailable$107.36
Bakersfield, CAUnavailable$108.47
Baltimore area, MDUnavailable$110.46
Beaumont, TXUnavailable$102.63
Brazoria, TXUnavailable$105.11

38242 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
38242 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 38242 rate is calculated

Each of 38242’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.

How the rate is built · 38242

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.06

2.06 RVUs× 1.000 GPCI

Practice expense0.97

0.97 RVUs× 1.000 GPCI

Malpractice0.14

0.14 RVUs× 1.000 GPCI

Adjusted RVUs

3.1700

Conversion factor

$33.4009

Medicare rate

$105.88

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 38242

The CMS indicators that decide how 38242 is paid alongside other services.

CMS payment indicators · 38242

Lymphocyte infusion

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

38242 without 51 · national facility

$105.88

Lymphocyte infusion

38242-51 · Second procedure: 50%

$52.94

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

38242 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 38242

    Lymphocyte infusion2.06 wRVU

    Not priced

  • 38240

    Not on the physician fee schedule3.9 wRVU

    Not priced

  • 38241

    Not on the physician fee schedule2.93 wRVU

    Not priced

  • 38243

    Cell boost2.08 wRVU

    Not priced

How to choose

38240Transplt allo hct/donor
38240 describes an allogeneic hematopoietic cell transplant. Use 38242 for a donor lymphocyte infusion, such as one given after an earlier transplant.
38241Transplt autol hct/donor
38241 is for an autologous hematopoietic cell transplant using the patient's own cells; 38242 is for lymphocytes from an allogeneic donor.
38243Cell boost
38243 describes a hematopoietic progenitor cell boost. Select 38242 when the infused product and service are donor lymphocytes.

Codes related to 38242

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

Codes related to 38242
CodeHow it relatesNational office range
Same family
38240Transplt allo hct/donorAllogeneic hematopoietic cell transplant; distinct from a later donor lymphocyte infusion.No office rate
38241Transplt autol hct/donorAutologous hematopoietic cell transplant, using the recipient's own cells.No office rate
38243Cell boostHematopoietic progenitor cell boost, a different cellular therapy service.No office rate

38242 billing questions

When is this code appropriate instead of an allogeneic transplant code?

Use it for an infusion of donor lymphocytes, such as a donor lymphocyte infusion after a prior allogeneic transplant. A full allogeneic hematopoietic cell transplant is reported with 38240.

How does this differ from a hematopoietic cell boost?

This code describes donor lymphocyte infusion. Code 38243 is for a hematopoietic progenitor cell boost, a different cellular therapy service.

Is same-day preoperative or postoperative care separately included?

No. CMS assigns a 0-day global period, and same-day preoperative and postoperative care is included.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.

Can an assistant, co-surgeon, or surgical team be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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

Show the CMS file lines behind this rate
RVUs for 38242PPRRVU2026_Oct_nonQPP.csv, line 4,733 (RVU26D)

Open CMS sourceHow we calculate rates

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