CPT 38209
Global XXXWash harvest stem cells
CPT 38209 Billing & Documentation Guide
CPT code 38209 (Wash harvest stem cells) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.23, a non-facility practice expense RVU of 0.05, and a malpractice RVU of 0.03, a total non-facility RVU of 0.31 and facility RVU of 0.31. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $10.44, though rates vary from $9.59 to $13.85 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 38209, 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 38209 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Invalid for Medicare; not separately payable
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 0 units of 38209 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 38209
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.23 | 0.23 |
| Practice Expense RVU | 0.05 | 0.05 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 0.31 | 0.31 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 38209
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 | $10.48 | $10.48 | $10.18 - $11.47 | 29 |
| Florida | $11.31 | $11.31 | $10.78 - $11.95 | 3 |
| Georgia | $10.49 | $10.49 | $10.37 - $10.61 | 2 |
| Illinois | $11.24 | $11.24 | $10.77 - $11.71 | 4 |
| Michigan | $10.66 | $10.66 | $10.34 - $10.98 | 2 |
| North Carolina | $9.88 | $9.88 | $9.88 - $9.88 | 1 |
| New York | $11.27 | $11.27 | $9.97 - $12.02 | 5 |
| Ohio | $10.22 | $10.22 | $10.22 - $10.22 | 1 |
| Pennsylvania | $10.46 | $10.46 | $10.16 - $10.75 | 2 |
| Texas | $10.3 | $10.3 | $10.13 - $10.78 | 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 38209
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 38209 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36000 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 36410 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 37202 | Column 1 (primary), can be billed with modifier | 9 | Misuse of Column Two code with Column One code |
| 62318 | Column 1 (primary), can be billed with modifier | 9 | Misuse of Column Two code with Column One code |
| 62319 | Column 1 (primary), can be billed with modifier | 9 | Misuse of Column Two code with Column One code |
| 64415 | Column 1 (primary), can be billed with modifier | 9 | Misuse of Column Two code with Column One code |
| 64417 | Column 1 (primary), can be billed with modifier | 9 | Misuse of Column Two code with Column One code |
| 64450 | Column 1 (primary), can be billed with modifier | 9 | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 38209
What does CPT code 38209 mean? +
CPT code 38209 represents: Wash harvest stem cells. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of XXX.
What is the Medicare reimbursement for CPT 38209? +
The 2026 Medicare national average non-facility payment for CPT 38209 is $10.44. Rates range from $9.59 to $13.85 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 38209? +
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 38209? +
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 June 1, 2026.
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