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See a sample rate comparisonCPT 88267 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.
Fetal Cell Genetic Analysis, Chromosome (Genetic) Analysis Of Fetal Cells Obtained From Amniotic Fluid Or The Surface Of The Placenta To Detect Genetic Abnormalities.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Cytogenetic Studies |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 88267 |
| Medicaid Fee Schedule | View Medicaid rates for 88267 |
National average reimbursement for CPT 88267 by major payers:
$181.09
$179.15
$205.67
$274.29
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CPT 88267
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$455.21Published rateMatthew Lilley
Bend Memorial Clinic, PC
$188.57Published ratePrisma Health-Upstate, Prisma Health Ctr For Ped & Int Med-West
Prisma Health - Upstate
$169.71Published rateLeon Home Health, LLC, Leon At Home
$146.77Published rateRestorative Health Rehabilitation Inc
$35.00Published rate
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See a sample payer proposalCPT 88267 vs. Other Cytogenetic Studies Codes
The CPT 88267 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 88267 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 |
|---|---|---|
| 88262-CPT | Low | Analysis Of Genetic Tendencies, Chromosome Analysis Of Cells And Karyotypes (The Full Chromosome Set That Describes A Persons Genetic Makeup) With Banding. Banding Appears On Paired Chromosome Bundles That Are Stained. Analysis Checks For Genetic Anomalies And Recessive Traits. |
| 88263-CPT | Low | Chromosome Mosaicism Analysis, Chromosome Mosaicism Is A Condition That Occurs During Embryonic Development. Instead Of Identical Chromosomes Every So Often One Develops That Contributes To An Individual Having More Than One Type Of Genetic Makeup. |
| 88264-CPT | Low | Genetic Study For Cancer Risk, Full Chromosome Analysis Of 20 To 25 Cells To Check For Anomalies Consistent With A Specified Cancer. |
| 88267-CPT | Low | Fetal Cell Genetic Analysis, Chromosome (Genetic) Analysis Of Fetal Cells Obtained From Amniotic Fluid Or The Surface Of The Placenta To Detect Genetic Abnormalities. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88267. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88267 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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