38220 Dx bone marrow aspirations
What 38220 is
CMS fee schedule short descriptor: Dx bone marrow aspirations.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 38220 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 1.17 | 3.76 | 0.09 | 5.02 | $167.67 |
| Facility (hospital, ASC) | 1.17 | 0.40 | 0.09 | 1.66 | $55.45 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 38220 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 38220? These codes are bundled into it
38220 is a Column 1 code in 49 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
01112 | Anes bone marrow aspir&/bx | 0 - no modifier bypass | Check pair |
01120 | Anes px on bony pelvis | 0 - no modifier bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 1 - modifier may bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 1 - modifier may bypass | Check pair |
0232T | Njx platelet plasma | 1 - modifier may bypass | Check pair |
0481T | Njx autol wbc concentrate | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
10005 | Fna bx w/us gdn 1st les | 1 - modifier may bypass | Check pair |
10007 | Fna bx w/fluor gdn 1st les | 1 - modifier may bypass | Check pair |
10009 | Fna bx w/ct gdn 1st les | 1 - modifier may bypass | Check pair |
10011 | Fna bx w/mr gdn 1st les | 1 - modifier may bypass | Check pair |
10021 | Fna bx w/o img gdn 1st les | 1 - modifier may bypass | Check pair |
20939 | Bone marrow aspir bone grfg | 1 - modifier may bypass | Check pair |
36000 | Place needle in vein | 1 - modifier may bypass | Check pair |
36410 | Vnpnxr 3yr/> phy/qhp dx/ther | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
61650 | Evasc prlng admn rx agnt 1st | 1 - modifier may bypass | Check pair |
62324 | Njx interlaminar crv/thrc | 1 - modifier may bypass | Check pair |
62325 | Njx interlaminar crv/thrc | 1 - modifier may bypass | Check pair |
62326 | Njx interlaminar lmbr/sac | 1 - modifier may bypass | Check pair |
62327 | Njx interlaminar lmbr/sac | 1 - modifier may bypass | Check pair |
64415 | Njx aa&/strd brch plxs img | 1 - modifier may bypass | Check pair |
64416 | Njx aa&/strd brch pl nfs img | 1 - modifier may bypass | Check pair |
64417 | Njx aa&/strd ax nerve img | 1 - modifier may bypass | Check pair |
64450 | Njx aa&/strd other pn/branch | 1 - modifier may bypass | Check pair |
64454 | Njx aa&/strd gnclr nrv brnch | 1 - modifier may bypass | Check pair |
64473 | Lwr xtr fscl pln blk uni njx | 1 - modifier may bypass | Check pair |
64474 | Lwr xtr fscl pln blk uni nfs | 1 - modifier may bypass | Check pair |
Showing 30 of 49 column 2 codes. Use the pair checker for any specific combination.
38220 is bundled into these codes
38220 appears as a Column 2 code in 209 active edits. Reported with one of these Column 1 codes on the same date of service, 38220 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0095T | Rmvl artific disc addl crvcl | 1 | Check pair |
0098T | Rev artific disc addl | 1 | Check pair |
0164T | Remove lumb artif disc addl | 1 | Check pair |
0165T | Revise lumb artif disc addl | 1 | Check pair |
0200T | Perq sacral augmt unilat inj | 1 | Check pair |
0201T | Perq sacral augmt bilat inj | 1 | Check pair |
0202T | Post vert arthrplst 1 lumbar | 1 | Check pair |
0219T | Plmt post facet implt cerv | 1 | Check pair |
0220T | Plmt post facet implt thor | 1 | Check pair |
0221T | Plmt post facet implt lumb | 1 | Check pair |
0222T | Plmt post facet implt addl | 1 | Check pair |
0263T | Im b1 mrw cel ther cmpl | 0 | Check pair |
0264T | Im b1 mrw cel ther xcl hrvst | 0 | Check pair |
0265T | Im b1 mrw cel ther hrvst onl | 0 | Check pair |
0274T | Prq lamot/lam dcmpr crv/thrc | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.