Price Checker / CPT 85097
CPT 85097 — Bone marrow interpretation
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$39
What Medicare pays in a hospital/ASC setting
$68
What Medicare pays in a physician's office
$3,732
Based on 38 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 85097
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| John Muir Health Walnut Creek Medical Center , CA | $33,716 | $15,172 | 49628% |
| ST JAMES HOSPITAL , NY | — | — | 11534% |
| Garden Grove Hospital Medical Center , CA | $4,527 | $1,396 | 6578% |
| Mercy Regional Medical Center , CO | $4,277 | $1,711 | 6208% |
| Chino Valley Medical Center , CA | $3,905 | $1,396 | 5659% |
| Montclair Hospital Medical Center , CA | $3,905 | $1,396 | 5659% |
| San Dimas Community Hospital , CA | $3,905 | $1,396 | 5659% |
| St. Thomas More Hospital , CO | $3,893 | $1,557 | 5642% |
| St. Mary-Corwin Medical Center , CO | $3,891 | $1,556 | 5639% |
| St. Anthony Summit Medical Center , CO | $3,872 | $1,549 | 5611% |
| UPMC Magee , PA | $3,816 | $3,053 | 5528% |
| UPMC Passavant-Cranberry , PA | $3,816 | $3,053 | 5528% |
| UPMC Passavant-McCandless , PA | $3,816 | $3,053 | 5528% |
| UPMC Passavant , PA | $3,816 | $3,053 | 5528% |
| Ascension St. Vincent Hospital - Avon (St Vincent Hospital and Health Care Center Inc.) , IN | — | — | 4481% |
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About CPT 85097
CPT code 85097 refers to “Bone marrow interpretation”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $39 in a facility (hospital or ambulatory surgery center) and $68in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.