How much does Medicare pay for CPT 38222?

Medicare allowed an average of $96.05 per service and paid $74.42 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $654.10, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 38222?

Biopsy and aspiration of bone marrow sample for diagnosis. It was billed 89,037 times to 84,472 Medicare beneficiaries by 3,376 providers in 2024.

Does 38222 pay differently in an office than a hospital?

Yes. The allowed amount averaged $137.05 in an office setting and $84.62 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 38222 most?

Diagnostic Radiology, with 24,620 services from 1,120 clinicians. Next are Nurse Practitioner, Physician Assistant, Interventional Radiology.

CPT 38222

Biopsy and aspiration of bone marrow sample for diagnosis

$96.05Medicare-allowed amount per service, averaged across 89,037 services

Providers submitted

$654.10

Asking price, not received

Medicare allowed

$96.05

The fee schedule figure

Medicare paid

$74.42

Balance is patient coinsurance

Providers submitted an average of $654.10 for this code and Medicare allowed $96.05 — 6.8× 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 $74.42 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $137.05
Hospital / facility: $84.62

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. 19,403 services were billed in an office setting and 69,634 in a facility.

Services: 89,037
Beneficiaries: 84,472
Providers billing it: 3,376
Total allowed: $8,552,004

What Medicare pays for CPT 38222

Across 89,037 services billed by 3,376 providers to 84,472 beneficiaries, Medicare allowed an average of $96.05 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 38222

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	24,620	24,023	$78.74	1,120
Nurse Practitioner	21,358	19,900	$70.94	623
Physician Assistant	16,066	14,911	$69.34	469
Interventional Radiology	11,773	11,484	$78.77	504
Hematology-Oncology	7,861	7,288	$142.17	382
Pathology	2,051	1,994	$87.42	74
Medical Oncology	1,640	1,525	$140.95	88
Ambulatory Surgical Center	1,140	1,060	$1100.52	17
Internal Medicine	985	909	$118.99	35
Hematology	838	740	$109.60	34
Hematopoietic Cell Transplantation and Cellular Therapy	171	117	$69.44	5
Certified Clinical Nurse Specialist	158	155	$112.42	8
Hospitalist	94	89	$124.18	5
Radiation Oncology	53	50	$67.54	1
Pediatric Medicine	48	48	$79.90	1

38222 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
Texas	9,581	$94.92	$74.15	308
California	8,541	$97.24	$68.27	293
Florida	8,095	$90.42	$69.28	250
New York	5,174	$98.03	$67.84	199
Illinois	3,511	$92.95	$69.92	156
Pennsylvania	3,091	$72.90	$55.78	159
Ohio	3,044	$69.44	$54.95	130
Georgia	2,985	$79.01	$60.56	95
Virginia	2,964	$81.24	$63.39	120
Arkansas	2,802	$121.15	$102.42	48
Arizona	2,600	$231.64	$184.00	87
Tennessee	2,431	$99.31	$83.72	72
North Carolina	2,188	$67.67	$53.83	107
Michigan	1,845	$77.54	$59.39	78
Maryland	1,828	$99.04	$71.16	74
Missouri	1,795	$83.79	$66.54	91
Washington	1,744	$110.56	$83.43	71
Kansas	1,675	$113.86	$93.83	44
New Jersey	1,605	$113.16	$79.97	78
Wisconsin	1,543	$64.50	$51.49	64
Indiana	1,542	$74.39	$60.98	70
Massachusetts	1,494	$75.67	$54.81	65
Colorado	1,378	$92.79	$69.98	64
South Carolina	1,347	$73.23	$58.42	56
Oklahoma	1,313	$77.42	$63.13	41
Minnesota	1,213	$151.26	$117.94	44
Nebraska	1,052	$214.91	$175.91	39
Iowa	978	$80.25	$64.59	33
Kentucky	928	$129.24	$107.36	40
Oregon	864	$88.77	$67.26	37
Mississippi	792	$68.60	$56.16	26
Louisiana	792	$73.22	$58.65	32
Utah	748	$77.77	$61.61	37
Connecticut	669	$83.05	$59.05	35
Alabama	641	$82.89	$69.14	31
Nevada	556	$113.95	$88.38	26
South Dakota	432	$74.04	$57.77	12
Idaho	425	$59.81	$49.24	22
North Dakota	417	$66.56	$52.60	14
West Virginia	380	$73.82	$58.77	18
Montana	303	$69.61	$53.98	17
New Hampshire	298	$74.76	$55.16	17
Delaware	271	$77.02	$59.18	12
Vermont	214	$65.21	$46.90	9
New Mexico	205	$84.20	$63.12	14
District of Columbia	190	$80.48	$56.70	10
Maine	177	$72.13	$56.10	11
Alaska	125	$137.40	$88.36	5
Hawaii	109	$111.77	$79.33	6
Rhode Island	69	$69.31	$50.81	4
Wyoming	60	$129.28	$104.01	4
Puerto Rico	13	$72.21	$55.63	1

Related codes

38206Collection of stem cells for transplantation$73.22
38221Biopsy of bone marrow$117.32
38220Aspiration of bone marrow sample for diagnosis$69.39

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.