CPT 88291 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 • Cytogenetic Studies |
| Common Place of Service | • 81 - Independent Laboratory • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • XU - Unusual Non-Overlapping Service • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 88291 |
National average reimbursement for CPT 88291 by major payers:

$38.01

$27.31

$39.99

$33.07
| 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 88291 | ||||||
United | 88291 | $36.41 | 1003332685 - ASTI REGO | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Family Nurse Practitioner (363LF0000X) |
United | 88291 | $42.84 | 1669810271 - SERGIY KUSHCHAYEV | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 88291 | $36.41 | 1770539983 - JUDY SCHAFFER | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Nurse Practitioner (363L00000X) |
United | 88291 | $27.55 | 1811940976 - MACON NORTHSIDE HOSPITAL, LLC, PIEDMONT MACON NORTH HOSPITAL | 621736985 - (GA) MACON NORTHSIDE HOSPITAL LLC | GA | General Acute Care Hospital (282N00000X) |
United | 88291 | $42.84 | 1023241734 - AMREESH MAHIL | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Anesthesiology Physician (207L00000X) |
United | 88291 | $20.79 | 1619087590 - MIGUEL ARENAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Gastroenterology Physician (207RG0100X) |
United | 88291 | $37.29 | 1497207146 - MELANIE SMITH | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Registered Dietitian (133V00000X) |
United | 88291 | $34.61 | 1821017831 - BACON COUNTY HEALTH SERVICES, INC, BACON COUNTY RURAL HEALTH CLINIC | 582224545 - (GA) BACON COUNTY HEALTH SERVICES INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | 88291 | $42.84 | 1740515162 - BENJAMIN POWERS | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Surgery Physician (208600000X) |
United | 88291 | $19.15 | 1174078281 - DERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC, ORLANDO DERMATOLOGY CENTER | 208048424 - (FL) DERMATOLOGY AND SKIN CANCER SURGERY CENTER LLC | FL | Dermatology Physician (207N00000X) |
United | 88291 | $20.79 | 1962633289 - ROUZBEH AFSARI | 953841576 - (CA) RENAL CONSULTANTS MEDICAL GROUP | CA | Nephrology Physician (207RN0300X) |
United | 88291 | $42.84 | 1033773148 - GAUTHIER STEPMAN | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | General Practice Physician (208D00000X) |
United | 88291 | $27.55 | 1962461681 - PIEDMONT HOSPITAL, INC, PIEDMONT HOSPITAL | 580566213 - (GA) PIEDMONT HEALTHCARE INC | GA | General Acute Care Hospital (282N00000X) |
United | 88291 | $20.79 | 1871500389 - ANANT DESAI | 953841576 - (CA) RENAL CONSULTANTS MEDICAL GROUP | CA | Nephrology Physician (207RN0300X) |
United | 88291 | $36.41 | 1346619129 - BLANCA LOPEZ | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
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 88291 vs. Other Cytogenetic Studies Codes
The CPT 88291 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 88291 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88291. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88291 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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