CPT 88240 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 | Cytogenetic Studies Pathology and Laboratory Procedures |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 88240 |
National average reimbursement for CPT 88240 by major payers:
$11.28
$11.21
$15.95
$19.46
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 88240 | $18.82 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 88240 | $7.84 | 1619087590 - MIGUEL ARENAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Gastroenterology Physician (207RG0100X) |
United | 88240 | $17.02 | 1851390637 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 88240 | $13.07 | 1497944565 - MICHAEL SHULER | 581076549 - ATHENS ORTHOPEDIC CLINIC, P.A. | GA | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 88240 | $5.54 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 88240 | $17.02 | 1013915149 - BAYCARE HOME CARE, INC., DBA SARASOTA MEMORIAL HOME CARE | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 88240 | $7.84 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 88240 | $16.94 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 88240 | $7.84 | 1386965267 - RENAL CONSULTANTS MEDICAL GROUP | 953841576 - (CA) RENAL CONSULTANTS MEDICAL GROUP | CA | Nephrology Physician (207RN0300X) |
United | 88240 | $40.00 | 1649599168 - RESTORATIVE HEALTH REHABILITATION INC | 272533824 - (FL) RESTORATIVE HEALTH REHABILITATION INC | FL | Home Health Agency (251E00000X) |
United | 88240 | $7.84 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 88240 | $17.02 | 1235122029 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 88240 | $16.94 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 88240 | $18.82 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 88240 | $8.42 | 1730106824 - NEVADA EYE CARE PROFESSIONALS LITTLE & STEIN, LTD. | 880316581 - NEVADA EYE CARE PROFESSIONALS | NV | Single Specialty Group (193400000X) |
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 88240 vs. Other Pathology and Laboratory Procedures Codes
The CPT 88240 code is part of the Cytogenetic Studies services used for Pathology and Laboratory 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 88240 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 |
|---|---|---|
| 88230-CPT | Low | White Blood Cell Culturing, Tissue Culture Of White Blood Cells (Wbcs) Or Lymphocytes For Routine Chromosome Analysis. Wbcs Are Taken From A Blood Sample And Placed Into A Material That Encourages The Cells To Multiply. These Are Used To Analyze Genetic Information. |
| 88233-CPT | Low | Tissue Culture, This Is A Lab Analysis Of A Sample Of Skin Muscle Bone Or Other Tissue That Has Been Surgically Removed. The Sample Is Placed Into A Growing Medium That Enables It To Create New Cells (Culture). Usually This Is Related To Genetic Studies. |
| 88235-CPT | Low | Fetal Cell Genetic Test, Culture Test Using Amniotic Fluid Or A Tissue Sample From The Placenta Surface. The Culture Encourages The Cells To Multiply So They Can Be Analyzed For Potential Fetal Genetic Disorders. |
| 88240-CPT | Low | Cell Freezing And Cold Storage, Cells Taken As Samples For Testing Or That Need To Be Examined Further Are Preserved By Freezing. Each Sample Must Be Prepared Carefully To Ensure The Information In The Tissue Is Not Altered. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88240. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88240 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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