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CMS RVU26D · Effective 2026-10-01

38220 Marrow aspiration Medicare reimbursement rates in New Jersey

Reports needle aspiration of bone marrow for diagnostic evaluation, such as obtaining marrow material for hematologic testing or microscopic review. Compare 38220 office and facility rates across CMS payment localities in New Jersey.

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 38220 in New Jersey?

New Jersey 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

$181.08–$190.43

2 of 2 localities have a supported rate.

Lowest: Rest Of New Jersey

Highest: Northern Nj

A spread of $9.35 per service.

Facility setting

$58.53–$60.25

2 of 2 localities have a supported rate.

Lowest: Rest Of New Jersey

Highest: Northern Nj

A spread of $1.72 per service.

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.

Find 38220 in your payment locality →

Hematology procedure

About 38220: Diagnostic bone marrow aspiration

Reports needle aspiration of bone marrow for diagnostic evaluation, such as obtaining marrow material for hematologic testing or microscopic review.

A clinician advances an aspiration needle into marrow, commonly at the posterior iliac crest, and withdraws liquid marrow for diagnostic studies. Hematologists and oncologists often perform the procedure in an office, clinic, or hospital setting; interventional radiologists may perform it with image guidance when clinically needed. The aspirate can support evaluation of suspected marrow disorders, cytopenias, or hematologic malignancy. This code describes aspiration, not removal of a core tissue specimen.

Select this service when diagnostic marrow is aspirated without a marrow biopsy during the encounter. When both aspiration and biopsy are performed, use 38222 rather than separately reporting 38220 and 38221. Documentation should identify the diagnostic purpose, procedure site, and aspiration performed. 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 others at 50%. For a bilateral procedure reported with modifier 50, CMS pays at 150%.

CMS billing rules for 38220

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 RVU1.17 · 23%
  • Practice expense (office) RVU3.76 · 75%
  • Malpractice RVU0.09 · 2%

3.5K

Medicare services in 2024 · #2077 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.

38220 compared with similar codes

Office rates for New Jersey, from the same CMS release.

38221

Bone marrow biopsy

Biopsy without aspiration

$180.22–$189.34

Choose 38221 when a marrow core biopsy is obtained without diagnostic aspiration. Aspiration alone is reported with 38220.

38222

Bone marrow exam

Aspiration and biopsy

$190.90–$200.41

Choose 38222 when diagnostic aspiration and biopsy are both performed during the encounter; do not report 38220 and 38221 separately for that combination.

38230

Marrow harvest

Allogeneic donor

No office rate

38230 is for allogeneic bone marrow harvest, a donor collection service rather than diagnostic aspiration.

Compare 38220 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

Office and facility base rates · shared scale starting at $0

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38220 billing questions

How is 38220 different from 38221?

38220 represents aspiration of liquid marrow for diagnostic testing; 38221 represents obtaining a core biopsy specimen. Use 38222 when both aspiration and biopsy are performed.

Can 38220 and 38221 be reported together for the same encounter?

When both diagnostic aspiration and biopsy are performed, report 38222 rather than separately reporting 38220 and 38221.

Does 38220 include interpretation of the marrow specimen?

The procedure code represents obtaining the aspirate. A pathologist may separately report marrow smear interpretation, such as 85097, when that service is performed and documented.

How does CMS price bilateral aspiration?

CMS pays a bilateral procedure reported with modifier 50 at 150%. Document the bilateral procedure and report modifier 50 when appropriate.

What happens when other procedures are performed in the same session?

Under the standard multiple-procedure reduction, CMS pays the highest-valued procedure in full and the other applicable procedures at 50% when performed in the same session.

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 38220PPRRVU2026_Oct_nonQPP.csv, line 4,722 (RVU26D)