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See a sample rate comparisonCPT 88245 Fee Schedule
Last Verified: September 2026
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.
Chromosome Breakage Analysis, Chromosome Breakage Affects An Individuals Genetic Makeup. Breakage May Appear As A Weakness In The Chromosome Strand Or As Rearrangement Of Characteristics Rather Than Exact Copies In Each Strand.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Cytogenetic Studies |
| Common Place of Service | 81 - Independent Laboratory |
| Common Modifiers | None PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments XE - Separate encounter |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 88245 |
| Medicaid Fee Schedule | View Medicaid rates for 88245 |
National average reimbursement for CPT 88245 by major payers:
$167.51
$150.35
$173.60
$252.44
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CPT 88245
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$418.03Published rateChristopher Raio
St Joseph Hospital
$249.36Published rateChristopher Raio
Mercy Medical Center
$148.44Published rateRenal Consultants Medical Group
$103.90Published rateChristopher Raio
St Francis Hospital
$42.75Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 88245 vs. Other Cytogenetic Studies Codes
The CPT 88245 code is part of the Pathology and Laboratory Procedures services used for Cytogenetic Studies. 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 88245 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 |
|---|---|---|
| 88241-CPT | Low | Cell Thawing, Cells That Have Been Frozen For Long-Term Storage Must Be Thawed Prior To Their Use Or Before Any Testing Can Be Done On Them. Each Cell Group Or Sample Is Thawed Separately. |
| 88245-CPT | Low | Chromosome Breakage Analysis, Chromosome Breakage Affects An Individuals Genetic Makeup. Breakage May Appear As A Weakness In The Chromosome Strand Or As Rearrangement Of Characteristics Rather Than Exact Copies In Each Strand. |
| 88248-CPT | Low | Chromosome Breakage Analysis, Chromosome Breakage Affects An Individuals Genetic Makeup. Breakage May Appear As A Weakness In The Chromosome Strand Or As Rearrangement Of Characteristics Rather Than Exact Copies In Each Strand. |
| 88249-CPT | Low | Chromosome Breakage Analysis, Chromosome Breakage Affects An Individuals Genetic Makeup. Breakage May Appear As A Weakness In The Chromosome Strand Or As Rearrangement Of Characteristics Rather Than Exact Copies In Each Strand. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88245. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88245 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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