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See a sample rate comparisonHealthcare 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 Cytogenetic Studies |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | $42.38 national lab fee schedule rate (2026) · View Medicare rates for 88274 |
| Medicaid Fee Schedule | $41.33 median of the 8 states in the free preview · View Medicaid rates for 88274 |
National average reimbursement for CPT 88274 by major payers:

$39.44

$44.09

$44.03

$60.19
Choose a payer to see a sample of rates for CPT 88274.
Sharron Acosta M.D.P.A.
Sharron Acosta, M.D., P.A.
Baycare Home Care, Inc.
Baycare Home Care Inc
Nicole Schwab
Allergy & Asthma Of Dupage, S.C.
Miguel Arenas
Miguel A Arenas Md PC
Christopher Raio
St Joseph Hospital
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Rate Benchmarking
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See a sample payer proposalCPT 88274 vs. Other Cytogenetic Studies Codes
The CPT 88274 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 88274 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 |
|---|---|---|
| 88272-CPT | Low | Chromosome Genetic Study, The Test Uses A Fluorescent Stain To Detect Dna Sequence In Cells. Dna Sequence Determines An Individuals Genetic Makeup. |
| 88273-CPT | Low | Molecular Cytogenetics Chromo, Molecular Cytogenetics Chromosomal In Situ Hybridizationanalyze 10-30 Cells (Eg For Microdeletions) Molecular Cytogenetics Chromosomal In Situ Hybridization |
| 88274-CPT | Low | Genetic Analysis Of Cells, This Study Uses A Technique That Separates And Recombines A Dna Strand Directly On A Viewing Slide. The Technique Analyzes How A Genetic Alteration Affects The Number Of Genes In A Specified Number Of Cells. |
| 88275-CPT | Low | Genetic Analysis Of Cells, This Study Uses A Technique That Separates And Recombines A Dna Strand Directly On A Viewing Slide. The Technique Analyzes How A Genetic Alteration Affects The Number Of Genes In A Specified Number Of Cells. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88274. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88274 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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