Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 88365 Fee Schedule
Last Verified: October 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.
Study Of Genetic Risk Factor, The Study Identifies Genetic Abnormalities In Tissues That Can Be Linked With Cancers Or Other Changes In The Body.
| 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 | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $169.01 national non-facility rate (2026) · View Medicare rates for 88365 |
| Medicaid Fee Schedule | $140.755 median of the 8 states in the free preview · View Medicaid rates for 88365 |
National average reimbursement for CPT 88365 by major payers:
$195.41
$142.15
$196.16
$183.00
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 88365.
CPT 88365
5 of 25 sample ratesHigher to lower in this preview
Sana Tabbara
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$220.60Published rateAlison Sheehan
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$187.50Published rateLeanne Zahn
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$139.27Published rateKaela Bacon
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$139.25Published rateValerie Michaud
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$48.24Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 88365 vs. Other Surgical Pathology Procedures Codes
The CPT 88365 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 88365 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 |
|---|---|---|
| 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) |
| 88365-CPT | Low | Study Of Genetic Risk Factor, The Study Identifies Genetic Abnormalities In Tissues That Can Be Linked With Cancers Or Other Changes In The Body. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88365. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88365 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 88365) and we'll show you how you compare in 15 minutes or less.