CPT 88342 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 • Surgical Pathology Procedures |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 81 - Independent Laboratory • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 88342 |
National average reimbursement for CPT 88342 by major payers:
$112.30
$86.32
$121.67
$109.67
| 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 88342 | ||||||
United | 88342 | $48.72 | 1952575888 - LISA REALE | 471859521 - (FL) BAPTIST HEALTH MEDICAL GROUP ONCOLOGY LLC | FL | Hematology & Oncology Physician (207RH0003X) |
United | 88342 | $52.72 | 1508880337 - JOHN SYLVESTER | 592485899 | FL | Radiation Oncology Physician (2085R0001X) |
United | 88342 | $40.84 | 1801865142 - CHAD LONG | 742978480 - (TX) AUSTIN GASTROENTEROLOGY, P.A. | TX | Gastroenterology Physician (207RG0100X) |
United | 88342 | $48.72 | 1821434929 - MARIA DOMINGUEZ | 471859521 - (FL) BAPTIST HEALTH MEDICAL GROUP ONCOLOGY LLC | FL | Hematology & Oncology Physician (207RH0003X) |
United | 88342 | $48.72 | 1407172497 - SANTIAGO APARO | 471859521 - (FL) BAPTIST HEALTH MEDICAL GROUP ONCOLOGY LLC | FL | Hematology & Oncology Physician (207RH0003X) |
United | 88342 | $81.26 | 1972664530 - BAPTIST HEALTH CARE, INC., GULF BREEZE HOSPITAL | 593608670 - (FL) BAPTIST HEALTH CARE INC | FL | General Acute Care Hospital (282N00000X) |
United | 88342 | $34.31 | 1639141054 - FREDERIC WIEN | 264709927 - WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES, P.C | NJ | Gastroenterology Physician (207RG0100X) |
United | 88342 | $152.38 | 1124472782 - BASHAR SHARMA | 60646768 - HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN GENERAL AND BRADLEY ME | NY | Gastroenterology Physician (207RG0100X) |
United | 88342 | $70.51 | 1619908217 - NOAH ZINKIN | 271664334 - (NY) NOAH ZINKIN, M.D., P.C. | NY | Gastroenterology Physician (207RG0100X) |
United | 88342 | $48.72 | 1588635668 - NEIL NAGOVSKI | 471859521 - (FL) BAPTIST HEALTH MEDICAL GROUP ONCOLOGY LLC | FL | Hematology & Oncology Physician (207RH0003X) |
United | 88342 | $44.29 | 1932101144 - BRIAN COSTLEIGH | 522046684 - (DE) DELMARVA RADIATION SERVICES PA | FL | Radiation Oncology Physician (2085R0001X) |
United | 88342 | $31.98 | 1952575888 - LISA REALE | 471859521 - (FL) BAPTIST HEALTH MEDICAL GROUP ONCOLOGY LLC | FL | Hematology & Oncology Physician (207RH0003X) |
United | 88342 | $167.94 | 1750541892 - NEHA SHARMA | 464088182 - (MI) MYMICHIGAN MEDICAL CENTER WEST BRANCH | FL | Radiation Oncology Physician (2085R0001X) |
United | 88342 | $70.90 | 1891026159 - DAVID SEAL | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 88342 | $112.33 | 1700226693 - JONELLE GEORGE | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MD | Gastroenterology Physician (207RG0100X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 88342 vs. Other Surgical Pathology Procedures Codes
The CPT 88342 code is part of the Pathology and Laboratory Procedures services used for Surgical Pathology 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 88342 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 |
|---|---|---|
| 88311-CPT | Low | Decalc Proced-List W/Surg.Path.Exam |
| 88312-CPT | Low | Special Stains (List Separately In Addition To Code For Primary Service); Group I For Microorganisms (Eg Gridley Acid Fast Methenamine Silver) Each (Rvsd 1/1/04) |
| 88341-CPT | Low | Immunohistochemistry Or Immunocytochemistry, Per Specimen; Each Additional Single Antibody Stain Procedure (List Separately In Addition To Code For Primary Procedure) |
| 88342-CPT | Low | Immunohistochemistry Or Immunocytochemistry Per Specimen; Initial Single Antibody Stain Procedure (Desc Revised 01/01/15) Separately Identifiable Antibody Per Slide (Revised 01/01/2014) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88342. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88342 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 88342) and we'll show you how you compare in 15 minutes or less.