38240
No office rateTransplt 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.
On this page
CMS RVU26D · Effective 2026-10-01
38242 Lymphocyte infusion Medicare reimbursement rates in Missouri
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 Missouri.
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 38242 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$101.29–$104.34
3 of 3 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.
Where 38242 pays more and less in Missouri
Hematology and transplantation
About 38242: Allogeneic donor lymphocyte infusion
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.
CMS billing rules for 38242
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.06 · 65%
- Practice expense (office) RVU0.97 · 31%
- Malpractice RVU0.14 · 4%
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.
38242 compared with similar codes
Office rates for Missouri, from the same CMS release.
38241
No office rateTransplt 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.
No office rate
38243 describes a hematopoietic progenitor cell boost. Select 38242 when the infused product and service are donor lymphocytes.
Compare 38242 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$103.80
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$104.34
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$101.29
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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 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.
4,73038232,,Bone marrow harvest autolog,A,,3.41,0.87,NA,0.87,,0.45,4.73,4.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73138240,,Transplt allo hct/donor,R,,3.90,1.89,NA,1.89,,0.25,6.04,6.04,0,XXX,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73238241,,Transplt autol hct/donor,R,,2.93,1.33,NA,1.33,,0.20,4.46,4.46,0,XXX,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73338242,,Transplt allo lymphocytes,A,,2.06,0.97,NA,0.97,,0.14,3.17,3.17,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73438243,,Transplj hematopoietic boost,A,,2.08,0.82,NA,0.82,,0.14,3.04,3.04,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73538300,,Drainage lymph node lesion,A,,2.30,8.42,,3.56,,0.61,11.33,6.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,73638305,,Drainage lymph node lesion,A,,6.51,6.46,NA,6.46,,1.74,14.71,14.71,0,090,0.11,0.73,0.16,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00