CPT 88362 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 |
| Common Modifiers | None 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 88362 |
| Medicaid Fee Schedule | View Medicaid rates for 88362 |
National average reimbursement for CPT 88362 by major payers:
$253.21
$209.87
$231.51
$250.00
CPT 88362 vs. Other Surgical Pathology Procedures Codes
The CPT 88362 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 88362 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 |
|---|---|---|
| 88356-CPT | Moderate | 3-D Genetic Analysis Of Tissue, Genetic Material From A Tissue Sample Is Studied Using Morphometric Analysis A Technique For Learning About The Cause And Progression Of A Disease. |
| 88362-CPT | Moderate | Nerve Teasing Preparations |
| 88363-CPT | Low | Examination And Selection Of R, Examination And Selection Of Retrieved Archival (Ie Previously Diagnosed) Tissue(S) For Molecular Analysis (Eg Kras Mutational Analysis) |
| 88364-CPT | Low | In Situ Hybridization (Eg Fis, In Situ Hybridization (Eg Fish) Per Specimen Each Additional Single Probe Stain Procedure (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88362. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88362 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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