$166.28–$181.47
38220 reports diagnostic marrow aspiration alone. Choose 38221 when a core biopsy is performed without aspiration.
On this page
CMS RVU26D · Effective 2026-10-01
38221 Bone marrow biopsy Medicare reimbursement rates in Oregon
Reports needle or trocar sampling of bone marrow for diagnostic evaluation when a core biopsy is performed without marrow aspiration. Compare 38221 office and facility rates across CMS payment localities in Oregon.
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 38221 in Oregon?
Oregon 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
$165.43–$180.23
2 of 2 localities have a supported rate.
Facility setting
$56.64–$58.88
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 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 Oregon, from the same CMS release.
$175.23–$190.64
38222 represents diagnostic marrow aspiration and core biopsy together. Use 38221 when the procedure is limited to the core biopsy.
No office rate
38230 is for harvesting marrow for allogeneic transplantation, not for obtaining a diagnostic core specimen.
Compare 38221 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
Portland →
Office / nonfacility
$180.23
Facility
$58.88
Rest Of Oregon →
Office / nonfacility
$165.43
Facility
$56.64
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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.
4,72038214,,Volume deplete of harvest,I,+,0.79,0.18,NA,0.18,,0.07,1.04,1.04,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
4,72138215,,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