Home / Medicare fees / 38222

38222 Dx bone marrow bx & aspir

What 38222 is

CMS fee schedule short descriptor: Dx bone marrow bx & aspir.

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 38222 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)1.403.770.135.30$177.02
Facility (hospital, ASC)1.400.340.131.87$62.46

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.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 38222 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 38222? These codes are bundled into it

38222 is a Column 1 code in 226 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 codeShort descriptionModifier indicator
01112Anes bone marrow aspir&/bx0 - no modifier bypassCheck pair
01120Anes px on bony pelvis0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0232TNjx platelet plasma1 - modifier may bypassCheck pair
0481TNjx autol wbc concentrate1 - modifier may bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
10005Fna bx w/us gdn 1st les1 - modifier may bypassCheck pair
10007Fna bx w/fluor gdn 1st les1 - modifier may bypassCheck pair
10009Fna bx w/ct gdn 1st les1 - modifier may bypassCheck pair
10011Fna bx w/mr gdn 1st les1 - modifier may bypassCheck pair
10021Fna bx w/o img gdn 1st les1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair

Showing 30 of 226 column 2 codes. Use the pair checker for any specific combination.

38222 is bundled into these codes

38222 appears as a Column 2 code in 207 active edits. Reported with one of these Column 1 codes on the same date of service, 38222 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0095TRmvl artific disc addl crvcl1Check pair
0098TRev artific disc addl1Check pair
0164TRemove lumb artif disc addl1Check pair
0165TRevise lumb artif disc addl1Check pair
0200TPerq sacral augmt unilat inj1Check pair
0201TPerq sacral augmt bilat inj1Check pair
0202TPost vert arthrplst 1 lumbar1Check pair
0219TPlmt post facet implt cerv1Check pair
0220TPlmt post facet implt thor1Check pair
0221TPlmt post facet implt lumb1Check pair
0222TPlmt post facet implt addl1Check pair
0263TIm b1 mrw cel ther cmpl0Check pair
0264TIm b1 mrw cel ther xcl hrvst0Check pair
0265TIm b1 mrw cel ther hrvst onl0Check pair
0274TPrq lamot/lam dcmpr crv/thrc1Check 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.