CPT 38206
Global 000Harvest auto stem cells
CPT 38206 Billing & Documentation Guide
CPT code 38206 (Harvest auto stem cells) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.46, a non-facility practice expense RVU of 0.47, and a malpractice RVU of 0.09, a total non-facility RVU of 2.02 and facility RVU of 2.02. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $68.72, though rates vary from $63.8 to $91.52 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 38206, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 38206 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Restricted coverage (special situations)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 38206 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 38206
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.46 | 1.46 |
| Practice Expense RVU | 0.47 | 0.47 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 2.02 | 2.02 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 38206
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $70.72 | $70.72 | $68.41 - $78.38 | 29 |
| Florida | $70.37 | $70.37 | $68.29 - $72.71 | 3 |
| Georgia | $67.41 | $67.41 | $66.35 - $68.47 | 2 |
| Illinois | $69.85 | $69.85 | $67.8 - $71.78 | 4 |
| Michigan | $67.74 | $67.74 | $66.49 - $68.98 | 2 |
| North Carolina | $65.33 | $65.33 | $65.33 - $65.33 | 1 |
| New York | $72.68 | $72.68 | $65.79 - $76.13 | 5 |
| Ohio | $66.13 | $66.13 | $66.13 - $66.13 | 1 |
| Pennsylvania | $67.79 | $67.79 | $66.02 - $69.57 | 2 |
| Texas | $67.28 | $67.28 | $65.84 - $68.88 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 38206
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 38206 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0540T | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0692T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 38206
What does CPT code 38206 mean? +
CPT code 38206 represents: Harvest auto stem cells. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 38206? +
The 2026 Medicare national average non-facility payment for CPT 38206 is $68.72. Rates range from $63.8 to $91.52 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 38206? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 38206? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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