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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.

38220

Marrow aspiration

Diagnostic aspirate

$174.69

38220 reports diagnostic marrow aspiration alone. Choose 38221 when a core biopsy is performed without aspiration.

38222

Bone marrow exam

Aspiration and biopsy

$183.93

38222 represents diagnostic marrow aspiration and core biopsy together. Use 38221 when the procedure is limited to the core biopsy.

38230

Marrow harvest

Allogeneic donor

No office rate

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

  1. Austin · This locality

    $173.72

  2. Beaumont

    $155.80

    $17.92 lower than Austin

  3. Brazoria

    $165.44

    $8.28 lower than Austin

  4. Dallas

    $166.37

    $7.35 lower than Austin

  5. Fort Worth

    $165.20

    $8.52 lower than Austin

  6. Galveston

    $165.86

    $7.86 lower than Austin

  7. Houston

    $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 / territoryRate rangeLocalities
AK$194.131
AL$150.211
AR$148.081
AZ$162.711
CA$177.68–$223.6329
CO$174.481
CT$177.971
DC$191.321
DE$165.381
FL$163.50–$177.613
GA$154.58–$169.812
GU$182.111
HI$182.111
IA$154.451
ID$155.341
IL$158.50–$173.424
IN$156.241
KS$153.511
KY$153.201
LA$152.87–$160.332
MA$173.37–$191.902
MD$168.58–$191.323
ME$155.89–$164.552
MI$156.90–$165.272
MN$167.941
MO$150.13–$161.183
MS$149.151
MT$167.001
NC$157.531
ND$164.821
NE$155.361
NH$171.531
NJ$180.22–$189.342
NM$157.651
NV$166.511
NY$159.83–$195.805
OH$156.461
OK$153.181
OR$165.43–$180.232
PA$156.83–$173.452
PR$168.291
RI$171.411
SC$157.211
SD$164.561
TN$154.241
TX$155.80–$173.728
UT$159.331
VA$163.86–$191.322
VI$168.291
VT$163.971
WA$173.11–$196.022
WI$159.361
WV$152.661
WY$166.051

Explore 38221 on the national rate map →

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.

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.

See the inputs behind this difference →

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.

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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
Office / nonfacility calculation for 38221 in Austin
ComponentRVULocality factorAdjusted
Physician work1.25× 1.0021.2525
Practice expense3.64× 1.0583.8511
Malpractice0.11× 0.8860.0975
Total RVUs5.2011
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

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.251.002
Practice expense3.641.058
Malpractice0.110.886

(1.25 × 1.002 + 3.64 × 1.058 + 0.11 × 0.886) × $33.4009 = $173.72

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.251.002
Practice expense0.371.058
Malpractice0.110.886

(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.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. 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.

  2. 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
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$173.72$58.16RVU26D
2026-07-01$173.72$58.16RVU26C
2026-04-01$173.72$58.16RVU26B
2026-01-01$173.72$58.16RVU26A
2025-10-01$160.75$67.71RVU25D
2025-07-01$160.75$67.71RVU25C
2025-04-01$160.75$67.71RVU25B
2025-01-01$160.75$67.71RVU25A

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.

RVUs for 38221PPRRVU2026_Oct_nonQPP.csv, line 4,723 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)