CPT 88175 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Pathology and Laboratory Procedures • Cytopathology Procedures |
| Common Place of Service | • 81 - Independent Laboratory • 11 - Office |
| Common Modifiers | • None • 90 - Reference Laboratory • 33 - Preventive Services |
| Complexity Level | Low |
National average reimbursement for CPT 88175 by major payers:
$26.62
$25.59
$31.28
$39.49
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 88175 | ||||||
United | 88175 | $26.61 | 1972709970 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE EAST CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 88175 | $23.20 | 1306843826 - WEST CARROLL HEALTH SYSTEMS LLC, WEST CARROLL MEMORIAL HOSPITAL | 562300247 - WEST CARROLL HEALTH SYSTEMS L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | 88175 | $26.61 | 1003344334 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE HORIZON CITY CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 88175 | $22.10 | 1194983510 - LYNN COUNTY HOSPITAL DISTRICT | 751328354 - (TX) LYNN COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 88175 | $15.53 | 1134126659 - CALDWELL MEMORIAL HOSPITAL INC | 720878037 - (LA) CALDWELL MEMORIAL HOSPITAL, INC. | LA | General Acute Care Hospital (282N00000X) |
United | 88175 | $22.76 | 1013068808 - ST HELENA PARISH HOSPITAL, ST HELENA PARISH HOSPITAL | 720627145 - (LA) ST HELENA PARISH HOSPITAL | LA | Critical Access Hospital (282NC0060X) |
United | 88175 | $22.20 | 1881665164 - CLHG-LEESVILLE, BYRD REGIONAL HOSPITAL | 824337635 | LA | General Acute Care Hospital (282N00000X) |
United | 88175 | $22.10 | 1275581852 - ROLLING PLAINS MEMORIAL HOSPITAL | 756003896 - (TX) THE NOLAN COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 88175 | $26.61 | 1447230388 - OPELOUSAS GENERAL HOSPITAL AUTHORITY | 720708111 | LA | General Acute Care Hospital (282N00000X) |
United | 88175 | $22.10 | 1457358103 - BELLVILLE HOSPITAL DISTRICT, BELLVILLE GENERAL HOSPITAL | 274005511 - BELLVILLE MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 88175 | $22.51 | 1013212448 - GUSTAVO DELGADO | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 88175 | $26.61 | 1205307378 - CHEROKEE MEDICAL CENTER, CMC WOUND SERVICES | 832531807 | SC | General Acute Care Hospital (282N00000X) |
United | 88175 | $26.61 | 1457382483 - AMISUB OF SOUTH CAROLINA, INC., PIEDMONT MEDICAL CENTER | 953561198 - (SC) AMISUB OF SOUTH CAROLINA INC | SC | General Acute Care Hospital (282N00000X) |
United | 88175 | $26.61 | 1831970532 - VHS SAN ANTONIO PARTNERS, LLC | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 88175 | $36.34 | 1588654966 - ST. JAMES PARISH HOSP. SERV. DIST. | 726010747 - (LA) ST JAMES PARISH HOSPITAL | LA | Critical Access Hospital (282NC0060X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 88175 vs. Other Cytopathology Procedures Codes
The CPT 88175 code is part of the Pathology and Laboratory Procedures services used for Cytopathology Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 88175 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 88142-CPT | Low | Cytopathology, Cervical Or Vaginal(Any Reporting System); Collected In Preservative Fluid, Automated Thin Layer Preparation, Screening By Cytotechnologist Under Physician Supervision |
| 88143-CPT | Low | Cytopathology, Cervical Or Vaginal (Any Reporting System), Collected In Preservative Fluid, Automated Thin Layer Preparation; With Manual Screening And Rescreening Under Physician Supervision |
| 88147-CPT | Low | Cytopathology Smears Cerv/Vag Screening By Automated System Under Md Supervision |
| 88175-CPT | Low | Cytopathology, Cervical Or Vaginal (Any Reporting System), Collected In Preservative Fluid, Automated Thin Layer Preparation; With Screening By Automated System And Manual Rescreening Or Review, Under Physician Supervision |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88175. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88175 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.
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