How much does Medicare pay for CPT 38220?

Medicare allowed an average of $69.39 per service and paid $54.04 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $713.24, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 38220?

Aspiration of bone marrow sample for diagnosis. It was billed 1,375 times to 1,267 Medicare beneficiaries by 63 providers in 2024.

Does 38220 pay differently in an office than a hospital?

Yes. The allowed amount averaged $87.70 in an office setting and $51.83 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 38220 most?

Hematology-Oncology, with 611 services from 23 clinicians. Next are Nurse Practitioner, Physician Assistant, Orthopedic Surgery.

CPT 38220

Aspiration of bone marrow sample for diagnosis

$69.39Medicare-allowed amount per service, averaged across 1,375 services

Providers submitted

$713.24

Asking price, not received

Medicare allowed

$69.39

The fee schedule figure

Medicare paid

$54.04

Balance is patient coinsurance

Providers submitted an average of $713.24 for this code and Medicare allowed $69.39 — 10.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $54.04 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $87.70
Hospital / facility: $51.83

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 673 services were billed in an office setting and 702 in a facility.

Services: 1,375
Beneficiaries: 1,267
Providers billing it: 63
Total allowed: $95,411

What Medicare pays for CPT 38220

Across 1,375 services billed by 63 providers to 1,267 beneficiaries, Medicare allowed an average of $69.39 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 38220

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hematology-Oncology	611	546	$80.22	23
Nurse Practitioner	264	252	$54.95	16
Physician Assistant	185	173	$58.03	10
Orthopedic Surgery	107	101	$34.66	2
Hematology	77	71	$86.41	5
Medical Oncology	59	53	$86.53	3
Podiatry	33	33	$31.90	2
Internal Medicine	20	19	$88.70	1
Pathology	19	19	$150.40	1

38220 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New Jersey	305	$86.19	$61.00	11
Texas	280	$56.78	$40.87	19
California	242	$69.94	$47.61	8
Indiana	126	$57.06	$45.80	2
Washington	66	$88.70	$65.82	3
New York	64	$85.71	$56.21	4
Alabama	64	$51.64	$40.87	4
Virginia	54	$64.00	$51.85	1
Maryland	47	$81.81	$58.28	2
Florida	29	$60.19	$46.05	2
South Dakota	20	$31.32	$25.82	1
Arizona	19	$75.84	$61.38	1
Louisiana	13	$138.55	$125.24	1
Illinois	12	$34.41	$25.93	1
District of Columbia	12	$34.32	$23.76	1
Pennsylvania	11	$31.64	$25.89	1
New Mexico	11	$33.88	$25.93	1

Related codes

38222Biopsy and aspiration of bone marrow sample for diagnosis$96.05
38206Collection of stem cells for transplantation$73.22
38221Biopsy of bone marrow$117.32

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.