CPT 38204
Status B Payment is bundled into another service. Not separately payable. Full definition →No national payment amount
Status B is not separately payable under the PFS.
Payment is bundled into another service. Not separately payable.
Common questions
Why is there no payment amount for 38204?
Its status indicator is B (bundled). Payment is bundled into another service. Not separately payable. The blank is deliberate: the amount is unknown or paid another way, not zero.
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October). Each release is versioned here, so past quarters stay lookupable — see what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Saw this code on your bill?
What is a 38204 visit in patient-friendly terms?
CPT 38204 is a billing code clinicians use to identify a specific service or procedure on a claim or explanation of benefits (EOB). We don't have a plain-language description on file for this exact code yet — ask your provider's billing office what service it represents, or bring it up at your next visit.
How this amount is computed
amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000.
| Component | RVU |
|---|---|
| Work RVU | blank |
| Practice expense RVU (non-facility) | blank |
| Practice expense RVU (facility) | blank |
| Malpractice RVU | blank |
Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A value of blank means CMS publishes no national number for that part — which is not the same as zero.
Rate history by release
National non-facility amount for 38204 across quarterly releases. Down 11.2% since Q1 2025 · high $97.04 in Q1 2025
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q3 2026 Jun 30, 2026 | B | $86.17 (0.0%) | $86.17 (0.0%) |
| Q2 2026 Mar 10, 2026 | B | $86.17 (0.0%) | $86.17 (0.0%) |
| Q1 2026 Dec 29, 2025 | B | $86.17 (-11.2%) | $86.17 (-11.2%) |
| Q4 2025 Sep 11, 2025 | B | $97.04 (0.0%) | $97.04 (0.0%) |
| Q3 2025 Jun 5, 2025 | B | $97.04 (0.0%) | $97.04 (0.0%) |
| Q2 2025 Jun 5, 2025 | B | $97.04 (0.0%) | $97.04 (0.0%) |
| Q1 2025 Dec 23, 2024 | B | $97.04 | $97.04 |
Billing together (NCCI edits)
NCCI Q3 2026Per CMS's National Correct Coding Initiative. Hover a code for when it's used.