$175.90
Use 85097 for interpretation alone. Code 38222 represents the combined aspiration, biopsy, and smear interpretation service.
On this page
CMS RVU26D · Effective 2026-10-01
85097 Marrow interpretation Medicare reimbursement rates in Wyoming
Reports a physician’s microscopic interpretation of bone marrow aspirate or biopsy material in the evaluation of hematologic disease. Compare 85097 office and facility rates across CMS payment localities in Wyoming.
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 85097 in Wyoming?
Wyoming 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.
Office / nonfacility
$67.37
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$38.64
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 pathology
About 85097: Bone marrow specimen interpretation
Reports a physician’s microscopic interpretation of bone marrow aspirate or biopsy material in the evaluation of hematologic disease.
A physician, commonly a pathologist or hematopathologist, examines bone marrow material and documents findings that help diagnose or classify conditions such as leukemia, myelodysplastic syndromes, plasma cell disorders, and unexplained cytopenias. The material may include aspirate smears or a marrow biopsy. The interpretation is a diagnostic service, not the collection of the specimen.
Report 85097 for the physician’s marrow interpretation when that service is separately performed and documented. The record should identify the material reviewed, the clinical question, and the physician’s interpretive findings in a signed report. If aspiration, biopsy, and smear interpretation are reported together under 38222, the interpretation is included in that combined service; do not separately report 85097 for the same interpretation. A separately examined core biopsy may also have a surgical pathology service reported when supported by the work performed.
Where the value comes from
- Work RVU0.92 · 45%
- Practice expense (office) RVU1.06 · 52%
- Malpractice RVU0.05 · 2%
133.3K
Medicare services in 2024 · #480 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.
85097 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$69.97
88305 represents surgical pathology examination of tissue, such as a submitted marrow core; 85097 reports interpretation of marrow material.
No office rate
85060 concerns a peripheral blood smear. Use 85097 when the material being interpreted is bone marrow.
Compare 85097 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.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
$67.37
Facility
$38.64
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How this local rate is calculated
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 85097 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
10,495
- Code
- 85097
- Physician work
- 0.92
- Practice expense
- 1.06
- Malpractice
- 0.05
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.92 | × 1.000 | 0.9200 |
| Practice expense | 1.06 | × 1.000 | 1.0600 |
| Malpractice | 0.05 | × 0.740 | 0.0370 |
| Total RVUs | 2.0170 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$67.37
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.92 | 1 |
| Practice expense | 1.06 | 1 |
| Malpractice | 0.05 | 0.74 |
(0.92 × 1 + 1.06 × 1 + 0.05 × 0.74) × $33.4009 = $67.37
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.92 | 1 |
| Practice expense | 0.2 | 1 |
| Malpractice | 0.05 | 0.74 |
(0.92 × 1 + 0.2 × 1 + 0.05 × 0.74) × $33.4009 = $38.64
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.
85097 billing questions
Is 85097 used to collect the marrow specimen?
No. It reports the physician’s interpretation of marrow material; aspiration and biopsy collection are represented by separate procedure services.
How does 85097 differ from 38222?
85097 reports interpretation alone. Code 38222 represents combined marrow aspiration and biopsy with smear interpretation, so the same interpretation should not be separately reported as 85097.
Can 85097 be reported with a marrow biopsy pathology service?
It may be reported with a separate surgical pathology examination when the core biopsy tissue is separately examined and the documentation supports both services.
What documentation supports 85097?
Keep the marrow material reviewed, the diagnostic reason for the study, and a signed report of the physician’s microscopic interpretation.
Should 85097 be used for a peripheral blood smear?
No. 85097 concerns bone marrow material; 85060 is the related interpretation service for a peripheral blood smear.
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.
10,49285049,,Automated platelet count,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10,49385055,,Reticulated platelet assay,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10,49485060,,Blood smear interpretation,A,,0.44,0.11,NA,0.11,,0.02,0.57,0.57,8,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10,49585097,,Bone marrow interpretation,A,,0.92,1.06,,0.20,,0.05,2.03,1.17,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10,49685130,,Chromogenic substrate assay,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10,49785170,,Blood clot retraction,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10,49885175,,Blood clot lysis time,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,