38220 reports diagnostic marrow aspiration alone. Choose 38221 when a core biopsy is performed without aspiration.
On this page
CMS RVU26D · Effective 2026-10-01
38221 in Austin
Office / nonfacility
$173.72
Base rate per service
Facility setting
$58.16
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Hematology procedure
About 38221: Diagnostic bone marrow core biopsy
Reports needle or trocar sampling of bone marrow for diagnostic evaluation when a core biopsy is performed without marrow aspiration.
A clinician obtains a core of marrow through a needle or trocar, most often from the posterior iliac crest, to evaluate suspected or known marrow disease. Hematologists and oncologists commonly perform the procedure in an office, clinic, or hospital setting, often using local anesthesia. Typical indications include unexplained cytopenias, suspected leukemia or lymphoma, plasma cell disorders, and assessment of marrow involvement. The specimen is sent for pathologic evaluation.
Report 38221 when a diagnostic core biopsy is performed without aspiration; when both biopsy and aspiration are performed, use 38222 instead. Documentation should identify the indication, biopsy site and side, and the procedure performed. For bilateral biopsies, CMS pays 150% when modifier 50 is reported. When this service and another procedure subject to the multiple-procedure rule are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
CMS billing rules for 38221
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
Where the value comes from
- Work RVU1.25 · 25%
- Practice expense (office) RVU3.64 · 73%
- Malpractice RVU0.11 · 2%
5.5K
Medicare services in 2024 · #1812 by national volume
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.
38221 compared with similar codes
Office rates for Austin, from the same CMS release.
38222 represents diagnostic marrow aspiration and core biopsy together. Use 38221 when the procedure is limited to the core biopsy.
38230 is for harvesting marrow for allogeneic transplantation, not for obtaining a diagnostic core specimen.
The same code, a different location
How does Austin compare?
In Beaumont, the office rate for 38221 is $155.80—$17.92 lower than the $173.72 rate in Austin. Both use the same code, release and participation basis.
38221 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
$173.72
$155.80
$17.92 lower than Austin
$165.44
$8.28 lower than Austin
$166.37
$7.35 lower than Austin
$165.20
$8.52 lower than Austin
$165.86
$7.86 lower than Austin
$167.87
$5.85 lower than Austin
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
Across 109 of 109 CMS payment localities with a supported office rate, 38221 ranges from $148.08 in Arkansas to $223.63 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 38221
Office
$160.45
Facility
$56.80
$13.27 lower than Austin for the office setting.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 38221
Office
$189.73
Facility
$60.52
$16.01 higher than Austin for the office setting.
Dc + Md/Va Suburbs
District of Columbia · 38221
Office
$191.32
Facility
$62.65
$17.60 higher than Austin for the office setting.
Miami
Florida · 38221
Office
$177.61
Facility
$63.91
$3.89 higher than Austin for the office setting.
Chicago
Illinois · 38221
Office
$172.66
Facility
$62.90
$1.06 lower than Austin for the office setting.
Manhattan
New York · 38221
Office
$191.53
Facility
$64.61
$17.81 higher than Austin for the office setting.
Alaska*
Alaska · 38221
Office
$194.13
Facility
$77.81
$20.41 higher than Austin for the office setting.
Alabama
Alabama · 38221
Office
$150.21
Facility
$54.64
$23.51 lower than Austin for the office setting.
Arkansas
Arkansas · 38221
Office
$148.08
Facility
$54.26
$25.64 lower than Austin for the office setting.
Arizona
Arizona · 38221
Office
$162.71
Facility
$56.87
$11.01 lower than Austin for the office setting.
Bakersfield
California · 38221
Office
$178.03
Facility
$58.33
$4.31 higher than Austin for the office setting.
Chico
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
El Centro
California · 38221
Office
$177.70
Facility
$57.99
$3.98 higher than Austin for the office setting.
Fresno
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Hanford-Corcoran
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Madera
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Merced
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Modesto
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Napa
California · 38221
Office
$206.49
Facility
$62.54
$32.77 higher than Austin for the office setting.
Oxnard-Thousand Oaks-Ventura
California · 38221
Office
$188.92
Facility
$59.82
$15.20 higher than Austin for the office setting.
Redding
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Rest Of California
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Riverside-San Bernardino-Ontario
California · 38221
Office
$178.89
Facility
$59.18
$5.17 higher than Austin for the office setting.
Sacramento-Roseville-Folsom
California · 38221
Office
$186.62
Facility
$59.60
$12.90 higher than Austin for the office setting.
Salinas
California · 38221
Office
$185.93
Facility
$59.34
$12.21 higher than Austin for the office setting.
San Diego-Chula Vista-Carlsbad
California · 38221
Office
$190.40
Facility
$59.78
$16.68 higher than Austin for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 38221
Office
$218.83
Facility
$64.83
$45.11 higher than Austin for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 38221
Office
$218.71
Facility
$64.70
$44.99 higher than Austin for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 38221
Office
$223.63
Facility
$66.13
$49.91 higher than Austin for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 38221
Office
$223.12
Facility
$65.62
$49.40 higher than Austin for the office setting.
San Luis Obispo-Paso Robles
California · 38221
Office
$182.91
Facility
$58.51
$9.19 higher than Austin for the office setting.
Santa Cruz-Watsonville
California · 38221
Office
$192.32
Facility
$59.61
$18.60 higher than Austin for the office setting.
Santa Maria-Santa Barbara
California · 38221
Office
$186.65
Facility
$59.30
$12.93 higher than Austin for the office setting.
Santa Rosa-Petaluma
California · 38221
Office
$194.27
Facility
$60.15
$20.55 higher than Austin for the office setting.
Stockton
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Vallejo
California · 38221
Office
$206.31
Facility
$62.36
$32.59 higher than Austin for the office setting.
Visalia
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Yuba City
California · 38221
Office
$177.68
Facility
$57.97
$3.96 higher than Austin for the office setting.
Colorado
Colorado · 38221
Office
$174.48
Facility
$58.27
$0.76 higher than Austin for the office setting.
Connecticut
Connecticut · 38221
Office
$177.97
Facility
$60.34
$4.25 higher than Austin for the office setting.
Delaware
Delaware · 38221
Office
$165.38
Facility
$57.47
$8.34 lower than Austin for the office setting.
Fort Lauderdale
Florida · 38221
Office
$171.55
Facility
$60.91
$2.17 lower than Austin for the office setting.
Rest Of Florida
Florida · 38221
Office
$163.50
Facility
$59.09
$10.22 lower than Austin for the office setting.
Atlanta
Georgia · 38221
Office
$169.81
Facility
$58.85
$3.91 lower than Austin for the office setting.
Rest Of Georgia
Georgia · 38221
Office
$154.58
Facility
$57.15
$19.14 lower than Austin for the office setting.
Hawaii, Guam
Hawaii · 38221
Office
$182.11
Facility
$57.93
$8.39 higher than Austin for the office setting.
Iowa
Iowa · 38221
Office
$154.45
Facility
$54.52
$19.27 lower than Austin for the office setting.
Idaho
Idaho · 38221
Office
$155.34
Facility
$54.86
$18.38 lower than Austin for the office setting.
East St. Louis
Illinois · 38221
Office
$161.00
Facility
$60.52
$12.72 lower than Austin for the office setting.
Rest Of Illinois
Illinois · 38221
Office
$158.50
Facility
$58.78
$15.22 lower than Austin for the office setting.
Suburban Chicago
Illinois · 38221
Office
$173.42
Facility
$61.25
$0.30 lower than Austin for the office setting.
Indiana
Indiana · 38221
Office
$156.24
Facility
$54.99
$17.48 lower than Austin for the office setting.
Kansas
Kansas · 38221
Office
$153.51
Facility
$54.77
$20.21 lower than Austin for the office setting.
Kentucky
Kentucky · 38221
Office
$153.20
Facility
$56.10
$20.52 lower than Austin for the office setting.
New Orleans
Louisiana · 38221
Office
$160.33
Facility
$57.55
$13.39 lower than Austin for the office setting.
Rest Of Louisiana
Louisiana · 38221
Office
$152.87
Facility
$56.21
$20.85 lower than Austin for the office setting.
Metropolitan Boston
Massachusetts · 38221
Office
$191.90
Facility
$61.49
$18.18 higher than Austin for the office setting.
Rest Of Massachusetts
Massachusetts · 38221
Office
$173.37
Facility
$58.36
$0.35 lower than Austin for the office setting.
Baltimore/Surr. Cntys
Maryland · 38221
Office
$177.42
Facility
$60.22
$3.70 higher than Austin for the office setting.
Rest Of Maryland
Maryland · 38221
Office
$168.58
Facility
$58.05
$5.14 lower than Austin for the office setting.
Rest Of Maine
Maine · 38221
Office
$155.89
Facility
$55.41
$17.83 lower than Austin for the office setting.
Southern Maine
Maine · 38221
Office
$164.55
Facility
$56.32
$9.17 lower than Austin for the office setting.
Detroit
Michigan · 38221
Office
$165.27
Facility
$59.87
$8.45 lower than Austin for the office setting.
Rest Of Michigan
Michigan · 38221
Office
$156.90
Facility
$57.18
$16.82 lower than Austin for the office setting.
Minnesota
Minnesota · 38221
Office
$167.94
Facility
$55.56
$5.78 lower than Austin for the office setting.
Metropolitan Kansas City
Missouri · 38221
Office
$159.50
Facility
$56.95
$14.22 lower than Austin for the office setting.
Metropolitan St. Louis
Missouri · 38221
Office
$161.18
Facility
$57.20
$12.54 lower than Austin for the office setting.
Rest Of Missouri
Missouri · 38221
Office
$150.13
Facility
$55.98
$23.59 lower than Austin for the office setting.
Mississippi
Mississippi · 38221
Office
$149.15
Facility
$55.11
$24.57 lower than Austin for the office setting.
Montana**
Montana · 38221
Office
$167.00
Facility
$57.78
$6.72 lower than Austin for the office setting.
North Carolina
North Carolina · 38221
Office
$157.53
Facility
$55.63
$16.19 lower than Austin for the office setting.
North Dakota**
North Dakota · 38221
Office
$164.82
Facility
$55.60
$8.90 lower than Austin for the office setting.
Nebraska
Nebraska · 38221
Office
$155.36
Facility
$54.55
$18.36 lower than Austin for the office setting.
New Hampshire
New Hampshire · 38221
Office
$171.53
Facility
$57.83
$2.19 lower than Austin for the office setting.
Northern Nj
New Jersey · 38221
Office
$189.34
Facility
$62.64
$15.62 higher than Austin for the office setting.
Rest Of New Jersey
New Jersey · 38221
Office
$180.22
Facility
$60.95
$6.50 higher than Austin for the office setting.
New Mexico
New Mexico · 38221
Office
$157.65
Facility
$57.50
$16.07 lower than Austin for the office setting.
Nevada**
Nevada · 38221
Office
$166.51
Facility
$57.18
$7.21 lower than Austin for the office setting.
Nyc Suburbs/Long Island
New York · 38221
Office
$195.80
Facility
$65.94
$22.08 higher than Austin for the office setting.
Poughkpsie/N Nyc Suburbs
New York · 38221
Office
$181.20
Facility
$61.61
$7.48 higher than Austin for the office setting.
Queens
New York · 38221
Office
$193.43
Facility
$64.33
$19.71 higher than Austin for the office setting.
Rest Of New York
New York · 38221
Office
$159.83
Facility
$56.07
$13.89 lower than Austin for the office setting.
Ohio
Ohio · 38221
Office
$156.46
Facility
$56.74
$17.26 lower than Austin for the office setting.
Oklahoma
Oklahoma · 38221
Office
$153.18
Facility
$55.64
$20.54 lower than Austin for the office setting.
Portland
Oregon · 38221
Office
$180.23
Facility
$58.88
$6.51 higher than Austin for the office setting.
Rest Of Oregon
Oregon · 38221
Office
$165.43
Facility
$56.64
$8.29 lower than Austin for the office setting.
Metropolitan Philadelphia
Pennsylvania · 38221
Office
$173.45
Facility
$59.75
$0.27 lower than Austin for the office setting.
Rest Of Pennsylvania
Pennsylvania · 38221
Office
$156.83
Facility
$56.57
$16.89 lower than Austin for the office setting.
Puerto Rico
Puerto Rico · 38221
Office
$168.29
Facility
$57.86
$5.43 lower than Austin for the office setting.
Rhode Island
Rhode Island · 38221
Office
$171.41
Facility
$58.59
$2.31 lower than Austin for the office setting.
South Carolina
South Carolina · 38221
Office
$157.21
Facility
$56.29
$16.51 lower than Austin for the office setting.
South Dakota**
South Dakota · 38221
Office
$164.56
Facility
$55.34
$9.16 lower than Austin for the office setting.
Tennessee
Tennessee · 38221
Office
$154.24
Facility
$54.96
$19.48 lower than Austin for the office setting.
Utah
Utah · 38221
Office
$159.33
Facility
$56.67
$14.39 lower than Austin for the office setting.
Virginia
Virginia · 38221
Office
$163.86
Facility
$56.49
$9.86 lower than Austin for the office setting.
Virgin Islands
United States Virgin Islands · 38221
Office
$168.29
Facility
$57.86
$5.43 lower than Austin for the office setting.
Vermont
Vermont · 38221
Office
$163.97
Facility
$55.84
$9.75 lower than Austin for the office setting.
Rest Of Washington
Washington · 38221
Office
$173.11
Facility
$58.10
$0.61 lower than Austin for the office setting.
Seattle (King Cnty)
Washington · 38221
Office
$196.02
Facility
$62.00
$22.30 higher than Austin for the office setting.
Wisconsin
Wisconsin · 38221
Office
$159.36
Facility
$54.72
$14.36 lower than Austin for the office setting.
West Virginia
West Virginia · 38221
Office
$152.66
Facility
$57.75
$21.06 lower than Austin for the office setting.
Wyoming**
Wyoming · 38221
Office
$166.05
Facility
$56.83
$7.67 lower than Austin for the office setting.
See how rates vary across the country
38221 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$148.08
$200.66
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $194.13 | 1 |
| AL | $150.21 | 1 |
| AR | $148.08 | 1 |
| AZ | $162.71 | 1 |
| CA | $177.68–$223.63 | 29 |
| CO | $174.48 | 1 |
| CT | $177.97 | 1 |
| DC | $191.32 | 1 |
| DE | $165.38 | 1 |
| FL | $163.50–$177.61 | 3 |
| GA | $154.58–$169.81 | 2 |
| GU | $182.11 | 1 |
| HI | $182.11 | 1 |
| IA | $154.45 | 1 |
| ID | $155.34 | 1 |
| IL | $158.50–$173.42 | 4 |
| IN | $156.24 | 1 |
| KS | $153.51 | 1 |
| KY | $153.20 | 1 |
| LA | $152.87–$160.33 | 2 |
| MA | $173.37–$191.90 | 2 |
| MD | $168.58–$191.32 | 3 |
| ME | $155.89–$164.55 | 2 |
| MI | $156.90–$165.27 | 2 |
| MN | $167.94 | 1 |
| MO | $150.13–$161.18 | 3 |
| MS | $149.15 | 1 |
| MT | $167.00 | 1 |
| NC | $157.53 | 1 |
| ND | $164.82 | 1 |
| NE | $155.36 | 1 |
| NH | $171.53 | 1 |
| NJ | $180.22–$189.34 | 2 |
| NM | $157.65 | 1 |
| NV | $166.51 | 1 |
| NY | $159.83–$195.80 | 5 |
| OH | $156.46 | 1 |
| OK | $153.18 | 1 |
| OR | $165.43–$180.23 | 2 |
| PA | $156.83–$173.45 | 2 |
| PR | $168.29 | 1 |
| RI | $171.41 | 1 |
| SC | $157.21 | 1 |
| SD | $164.56 | 1 |
| TN | $154.24 | 1 |
| TX | $155.80–$173.72 | 8 |
| UT | $159.33 | 1 |
| VA | $163.86–$191.32 | 2 |
| VI | $168.29 | 1 |
| VT | $163.97 | 1 |
| WA | $173.11–$196.02 | 2 |
| WI | $159.36 | 1 |
| WV | $152.66 | 1 |
| WY | $166.05 | 1 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 38221 in Austin
Multiple payment areas
- 38221 in Barton Creek
- 38221 in Bee Cave
- 38221 in Briarcliff
- 38221 in Cedar Park
Multiple payment areas
- 38221 in Creedmoor
Multiple payment areas
- 38221 in Elgin
Multiple payment areas
- 38221 in Garfield
Why are the office and facility amounts different?
For 38221 in Austin, the physician’s office rate is $173.72 and the facility-setting rate is $58.16: a difference of $115.56.
The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 38221 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$191.09
$173.72 × 110% = $191.09
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 38221 in Austin.
PPRRVU2026_Oct_nonQPP.csv
4,723
- Code
- 38221
- Physician work
- 1.25
- Practice expense
- 3.64
- Malpractice
- 0.11
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.25 | × 1.002 | 1.2525 |
| Practice expense | 3.64 | × 1.058 | 3.8511 |
| Malpractice | 0.11 | × 0.886 | 0.0975 |
| Total RVUs | 5.2011 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Austin$173.72
Open 38221 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.25 | 1.002 |
| Practice expense | 3.64 | 1.058 |
| Malpractice | 0.11 | 0.886 |
(1.25 × 1.002 + 3.64 × 1.058 + 0.11 × 0.886) × $33.4009 = $173.72
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.25 | 1.002 |
| Practice expense | 0.37 | 1.058 |
| Malpractice | 0.11 | 0.886 |
(1.25 × 1.002 + 0.37 × 1.058 + 0.11 × 0.886) × $33.4009 = $58.16
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
38221 · Office / nonfacility
$173.72
Effective 2026-10-01
The base rate is $12.97 higher than on 2025-10-01, moving from $160.75 to $173.72 (8.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$160.75changed to$173.72
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.28 changed to 1.25
- Practice expense RVU 3.44 changed to 3.64
- Malpractice RVU 0.10 changed to 0.11
- Work GPCI 1.000 changed to 1.002
- Practice expense GPCI 1.046 changed to 1.058
- Malpractice GPCI 0.914 changed to 0.886
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $160.75
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
38221 billing questions
When should 38221 be chosen over 38222?
Use 38221 for a diagnostic marrow core biopsy without aspiration. When both a biopsy and aspiration are performed, report 38222.
Can marrow aspiration be reported separately with 38221?
When aspiration and biopsy are both performed, use 38222 rather than separately reporting 38220 with 38221.
How is a bilateral bone marrow biopsy reported?
Report modifier 50 for a bilateral procedure; CMS pays 150% under the supplied bilateral rule. Document the biopsy at both sites.
What documentation supports 38221?
Document the diagnostic indication, the site and side sampled, and that a needle or trocar core biopsy was performed without aspiration.
How does the multiple-procedure reduction affect 38221?
When another procedure subject to the rule is performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
