Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 88130 Fee Schedule
Medicare rates as of January 2026
CPT 88130 is classified under Pathology and Laboratory Procedures, in the Cytopathology Procedures subgroup.
Genetic Test For Gender, The Test Is Done Most Frequently On Amniotic Fluid To Determine The Gender Of A Fetus. The Sample Is Examined For The Presence Of An Inactive X Chromosome Or Barr Body. Males Have A Y Chromosome Rather Than An Inactive X Chromosome.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Cytopathology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $17.98 national lab fee schedule rate (2026) · View Medicare rates for 88130 |
| Medicaid Fee Schedule | $16.54 median of the 8 states in the free preview · View Medicaid rates for 88130 |
National average reimbursement for CPT 88130 by major payers:
$18.60
BCBS / Anthem
$16.01
UnitedHealthcare
$18.95
Aetna
$25.87
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 88130.
CPT 88130
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$55.00Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$43.40Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$25.89Published rateChildrens National Medical Center
Childrens Hospital
$17.98Published rateNocona Hospital District, Nocona General Hospital
$9.22Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 88130 vs. Other Cytopathology Procedures Codes
The table lists codes related to 88130. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 88108-CPT | Low | Laboratory Study Of Cells, Examination Of A Cell Sample Using Techniques To Identify If A Disease Is Present Or Not (Cytopathology). Results Are Interpreted For A Report. |
| 88125-CPT | Low | Lab Testing Related To A Crime, Material From A Body Such As Hair Skin Or Blood Is Collected From A Crime Scene And Tested In A Laboratory. The Purpose Is To Identify Or Exclude A Persons Involvement In The Crime. |
| 88130-CPT | Low | Genetic Test For Gender, The Test Is Done Most Frequently On Amniotic Fluid To Determine The Gender Of A Fetus. The Sample Is Examined For The Presence Of An Inactive X Chromosome Or Barr Body. Males Have A Y Chromosome Rather Than An Inactive X Chromosome. |
| 88140-CPT | Low | Genetic Test For Gender, The Test Is Done Most Frequently On Amniotic Fluid To Determine The Gender Of A Fetus. The Sample Is Examined For The Presence Of An Inactive X Chromosome Or Barr Body. Males Have A Y Chromosome Rather Than An Inactive X Chromosome. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88130. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88130 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 88130) and we'll show you how you compare in 15 minutes or less.