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See a sample rate comparisonCPT 88366 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.
Tissue Analysis, This Lab Analysis Examines Individual Cells In Tissue Samples To Identify Pathogens That Cause Disease Or Illness.
| 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 | Moderate |
| Medicare Fee Schedule | $265.20 national non-facility rate (2026) · View Medicare rates for 88366 |
| Medicaid Fee Schedule | $221.985 median of the 8 states in the free preview · View Medicaid rates for 88366 |
National average reimbursement for CPT 88366 by major payers:
$302.17
$198.07
$250.54
$275.97
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CPT 88366
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$722.07Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$308.79Published rateChristopher Raio
Mercy Medical Center
$201.53Published rateChristopher Raio
St Joseph Hospital
$72.13Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$26.68Published rate
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See a sample payer proposalCPT 88366 vs. Other Surgical Pathology Procedures Codes
The CPT 88366 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 88366 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) |
| 88366-CPT | Moderate | Tissue Analysis, This Lab Analysis Examines Individual Cells In Tissue Samples To Identify Pathogens That Cause Disease Or Illness. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88366. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88366 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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