$156.49–$165.43
38220 is for diagnostic marrow aspiration alone. Choose 38222 when a core biopsy is also obtained in the same session.
On this page
CMS RVU26D · Effective 2026-10-01
38222 Bone marrow exam Medicare reimbursement rates in Maine
Reports diagnostic bone marrow aspiration and core biopsy performed in the same session, commonly to evaluate unexplained cytopenias, suspected marrow disease, or hematologic malignancy. Compare 38222 office and facility rates across CMS payment localities in Maine.
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.
What does Medicare pay for 38222 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$165.31–$174.29
2 of 2 localities have a supported rate.
Facility setting
$59.91–$60.76
2 of 2 localities have a supported rate.
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 procedure
About 38222: Diagnostic bone marrow aspiration and biopsy
Reports diagnostic bone marrow aspiration and core biopsy performed in the same session, commonly to evaluate unexplained cytopenias, suspected marrow disease, or hematologic malignancy.
This code covers obtaining a bone marrow aspirate and a core biopsy for diagnostic evaluation during the same session. Hematologists, oncologists, and other qualified clinicians commonly perform the sampling, often from the posterior iliac crest, in an office procedure room, hospital, or outpatient facility. The samples can help evaluate unexplained anemia or other cytopenias, suspected marrow disorders, and hematologic malignancies.
Report this code when both aspiration and biopsy are performed; use 38220 for aspiration alone and 38221 for biopsy alone. Document the indication, sampling site or sites, and performance of both techniques. CMS applies the standard multiple procedure reduction when applicable procedures are performed in the same session: the highest-valued procedure is paid in full and other procedures at 50%. For a bilateral procedure reported with modifier 50, CMS pays 150%.
CMS billing rules for 38222
- 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 RVU1.40 · 26%
- Practice expense (office) RVU3.77 · 71%
- Malpractice RVU0.13 · 2%
124.2K
Medicare services in 2024 · #504 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.
38222 compared with similar codes
Office rates for Maine, from the same CMS release.
$155.89–$164.55
38221 is for diagnostic marrow biopsy alone. Choose 38222 when aspiration is performed along with the biopsy.
No office rate
38230 describes bone marrow harvest for allogeneic transplantation, not diagnostic sampling for evaluation of marrow disease.
Compare 38222 by payment locality
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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$165.31
Facility
$59.91
Southern Maine →
Office / nonfacility
$174.29
Facility
$60.76
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38222 billing questions
When should 38222 be chosen over 38220 or 38221?
Use 38222 when diagnostic aspiration and core biopsy are both performed in the same session. Use 38220 for aspiration alone or 38221 for biopsy alone.
Can 38220 and 38221 also be reported with 38222?
Do not separately report the aspiration-only or biopsy-only code for the same sampling already represented by 38222.
How is bilateral sampling reported?
When the service is performed bilaterally, report modifier 50. CMS pays a bilateral procedure reported with modifier 50 at 150%.
What documentation supports reporting 38222?
Document the diagnostic reason, the sampling site or sites, and that both aspiration and core biopsy were performed.
Are marrow specimen interpretation services included in 38222?
38222 represents the sampling procedure. Bone marrow smear interpretation or surgical pathology examination may be separately represented by codes such as 85097 or 88305 when those services are performed and documented.
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.
4,72138215,,Harvest stem cell concentrte,I,+,0.92,0.20,NA,0.20,,0.09,1.21,1.21,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,72238220,,Dx bone marrow aspirations,A,,1.17,3.76,,0.40,,0.09,5.02,1.66,0,XXX,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,72338221,,Dx bone marrow biopsies,A,,1.25,3.64,,0.37,,0.11,5.00,1.73,0,XXX,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,72438222,,Dx bone marrow bx & aspir,A,,1.40,3.77,,0.34,,0.13,5.30,1.87,0,XXX,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,72538225,,Car-t hrv bld-drv t lymphcyt,B,+,1.89,0.41,NA,0.41,,0.20,2.50,2.50,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,72638226,,Car-t prep t lymphcyt f/trns,B,+,0.77,0.17,NA,0.17,,0.07,1.01,1.01,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,72738227,,Car-t receipt&prepj admn,B,+,0.78,0.17,NA,0.17,,0.07,1.02,1.02,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00