CPT 38221 Surgery - Hemic/Lymphatic

Dx bone marrow biopsies Cost

Body System: Hemic/Lymphatic

Medicare Facility Rate
$58
CMS PFS CY2026
Medicare Non-Facility Rate
$167
Office/clinic setting
Hospital Outpatient
$1
OPPS rate
Surgery Center (ASC)
$123
ASC rate

Relative Value Units (RVUs)

Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)

1.25
Work RVU
0.37
Facility PE RVU
0.11
Malpractice RVU
5.00
Total RVU

Frequently Asked Questions

How much does Dx bone marrow biopsies cost?

The Medicare facility rate is $58. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $1. Ambulatory surgery center rate: $123.

How much does Dx bone marrow biopsies cost without insurance?

Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $58.

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