CPT 38220
Global XXX ActiveDx bone marrow aspirations
CPT 38220 Billing & Documentation Guide
CPT code 38220 (Dx bone marrow aspirations) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.17, a non-facility practice expense RVU of 3.76, and a malpractice RVU of 0.09, a total non-facility RVU of 5.02 and facility RVU of 1.66. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $173.52, though rates vary from $148.51 to $226.09 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 38220, 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 38220 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 38220 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 38220
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.17 | 1.17 |
| Practice Expense RVU | 3.76 | 0.4 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 5.02 | 1.66 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 38220
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 | $190.71 | $57.92 | $179 - $226.09 | 29 |
| Florida | $170.94 | $58.34 | $163.66 - $177.42 | 3 |
| Georgia | $162.55 | $55.48 | $154.69 - $170.4 | 2 |
| Illinois | $166.31 | $57.87 | $158.44 - $173.66 | 4 |
| Michigan | $161.24 | $55.86 | $157.13 - $165.34 | 2 |
| North Carolina | $158.17 | $53.47 | $158.17 - $158.17 | 1 |
| New York | $185.12 | $59.92 | $160.5 - $196.49 | 5 |
| Ohio | $156.77 | $54.31 | $156.77 - $156.77 | 1 |
| Pennsylvania | $165.66 | $55.73 | $157.21 - $174.11 | 2 |
| Texas | $165.73 | $55.24 | $156.16 - $174.69 | 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 38220
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 38220 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01112 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01120 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0232T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0481T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 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 |
| 10005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10007 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 38220
What does CPT code 38220 mean? +
CPT code 38220 represents: Dx bone marrow aspirations. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of XXX.
What is the Medicare reimbursement for CPT 38220? +
The 2026 Medicare national average non-facility payment for CPT 38220 is $173.52. Rates range from $148.51 to $226.09 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 38220? +
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 38220? +
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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