Transplt 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.
CMS RVU26D · Effective 2026-10-01
Reports infusion of donor lymphocytes into a transplant recipient, commonly after allogeneic stem cell transplantation to support a graft-versus-tumor response. Compare 38242 office and facility rates across CMS payment localities in Alaska.
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.
Alaska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
No supported rate
$140.29
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Hematology and transplantation
Reports infusion of donor lymphocytes into a transplant recipient, commonly after allogeneic stem cell transplantation to support a graft-versus-tumor response.
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.
240
Medicare services in 2024 · #4164 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.
Office rates for Alaska, from the same CMS release.
Transplt 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.
Transplt 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.
38243 describes a hematopoietic progenitor cell boost. Select 38242 when the infused product and service are donor lymphocytes.
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Office / nonfacility
Unavailable
Facility
$140.29
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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 38242 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
4,733
GPCI2026.csv
5
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.06 | × 1.500 | 3.0900 |
| Practice expense | 0.97 | × 1.065 | 1.0331 |
| Malpractice | 0.14 | × 0.551 | 0.0771 |
| Total RVUs | 4.2002 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alaska*$140.29
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.06 | 1.5 |
| Practice expense | 0.97 | 1.065 |
| Malpractice | 0.14 | 0.551 |
(2.06 × 1.5 + 0.97 × 1.065 + 0.14 × 0.551) × $33.4009 = $140.29
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.
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.
This code describes donor lymphocyte infusion. Code 38243 is for a hematopoietic progenitor cell boost, a different cellular therapy service.
No. CMS assigns a 0-day global period, and same-day preoperative and postoperative care is included.
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.
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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.