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Bone marrow cell implant therapy shows a potential difference of $2,170 between ambulatory surgery centers and hospital outpatient facilities, making it essential to verify your facility type before treatment.
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
Code 0264T covers implant bone marrow cell therapy, a procedure where previously harvested bone marrow cells are injected into a patient to promote healing or tissue regeneration. This treatment is typically billed for patients with orthopedic injuries, non-healing fractures, or certain degenerative conditions. As a Category III code, this procedure requires special documentation and may face coverage limitations from many insurance providers.
Non-facility rate
$99
Office setting benchmark
Data sources
4
23 data points
Key insights for CPT 0264T
ASC vs hospital outpatient savings
$2,170Having this done at an ambulatory surgery center costs $2,515 vs $4,685 at a hospital outpatient
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Non-facility (office) | $99 | Lowest |
| Outpatient (APC) | $4,685 | +4632% |
| Ambulatory surgery (ASC) | $2,515 | +2441% |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use