CPT 38222
Global XXX ActiveDx bone marrow bx & aspir
CPT 38222 Billing & Documentation Guide
CPT code 38222 (Dx bone marrow bx & aspir) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.4, a non-facility practice expense RVU of 3.77, and a malpractice RVU of 0.13, a total non-facility RVU of 5.3 and facility RVU of 1.87. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $182.85, though rates vary from $157.16 to $235.81 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 38222, 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 38222 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 38222 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 38222
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.4 | 1.4 |
| Practice Expense RVU | 3.77 | 0.34 |
| Malpractice RVU | 0.13 | 0.13 |
| Total RVU | 5.3 | 1.87 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 38222
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 | $199.79 | $64.23 | $187.89 - $235.81 | 29 |
| Florida | $181.56 | $66.61 | $173.67 - $188.83 | 3 |
| Georgia | $172.16 | $62.86 | $164.26 - $180.05 | 2 |
| Illinois | $176.89 | $66.2 | $168.51 - $184.1 | 4 |
| Michigan | $171.12 | $63.54 | $166.63 - $175.6 | 2 |
| North Carolina | $167.02 | $60.13 | $167.02 - $167.02 | 1 |
| New York | $195.36 | $67.55 | $169.44 - $207.54 | 5 |
| Ohio | $166.1 | $61.51 | $166.1 - $166.1 | 1 |
| Pennsylvania | $175.17 | $62.95 | $166.46 - $183.87 | 2 |
| Texas | $175.02 | $62.23 | $165.38 - $183.93 | 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 38222
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 38222 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 | 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 | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | 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 |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 38222
What does CPT code 38222 mean? +
CPT code 38222 represents: Dx bone marrow bx & aspir. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of XXX.
What is the Medicare reimbursement for CPT 38222? +
The 2026 Medicare national average non-facility payment for CPT 38222 is $182.85. Rates range from $157.16 to $235.81 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 38222? +
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 38222? +
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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