CPT 88371 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • 91 - Repeat Lab Test • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| CMS | $18.11 Physician Fee Schedule |
National average reimbursement for CPT 88371 by major payers:
$28.15
$20.83
$27.51
$36.01
| 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 88371 | ||||||
United | 88371 | $13.34 | 1013553197 - AMY MOORE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Acute Care Nurse Practitioner (363LA2100X) |
United | 88371 | $12.34 | 1790057420 - BAMA HEART DOC, P.C., ALABAMA HEART AND VASCULAR MEDICINE | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | 88371 | $12.34 | 1952557498 - JEREMY KELLEY | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Family Nurse Practitioner (363LF0000X) |
United | 88371 | $22.22 | 1023065794 - CHCA WOMANS HOSPITAL LP, WOMAN'S HOSPITAL OF TEXAS | 621810381 - (TX) CHCA WOMANS HOSPITAL LP | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $22.22 | 1720033947 - ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP, HEART HOSPITAL OF AUSTIN | 742781812 | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $18.54 | 1457358103 - BELLVILLE HOSPITAL DISTRICT, BELLVILLE GENERAL HOSPITAL | 274005511 - BELLVILLE MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $22.22 | 1750819025 - NORTH HOUSTON, HCA HOUSTON HEALTHCARE TOMBALL | 821349955 | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $22.22 | 1306897277 - COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP, MEDICAL CITY DENTON | 621682213 - (TX) COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $13.34 | 1740273994 - ECTOR COUNTY HOSPITAL DISTRICT, MEDICAL CENTER HOSPITAL | 752302928 | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $18.54 | 1457358103 - BELLVILLE HOSPITAL DISTRICT, BELLVILLE GENERAL HOSPITAL | 274005511 - BELLVILLE MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $22.22 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $22.22 | 1609135904 - ANDREW CORONA | 922417967 | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $18.54 | 1801893417 - SMITHVILLE HOSPITAL AUTHORITY, SMITHVILLE REGIONAL HOSPITAL | 741706734 | TX | General Acute Care Hospital (282N00000X) |
United | 88371 | $18.62 | 1881665164 - CLHG-LEESVILLE, BYRD REGIONAL HOSPITAL | 824337635 | LA | General Acute Care Hospital (282N00000X) |
United | 88371 | $12.34 | 1750474516 - NORTHWEST TEXAS SURGICAL HOSPITAL, LLC, NORTHWEST TEXAS SURGERY CENTER | 233086987 - (TX) NORTHWEST TEXAS SURGICAL HOSPITAL LLC | TX | General Acute Care Hospital (282N00000X) |
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 88371 vs. Other Surgical Pathology Procedures Codes
The CPT 88371 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 88371 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 |
|---|---|---|
| 88371-CPT | Low | Prot Anal Tiss West Blot Inter/Rept |
| 88372-CPT | Low | Protein Analysis Of Tissue By Western Blot, With Interpretation And Report; Immunological Probe For Band Identification, Each |
| 88373-CPT | Low | Morphometric Analysis In Situ Hybridization (Quantitative Or Semi-Quantitative) Using Computer-Assisted Technology Per Specimen; Each Additional Single Probe Stain Procedure (List Separately In Addition To Code For Primary Procedure) |
| 88374-CPT | Moderate | Morphometric Analysis In Situ Hybridization (Quantitative Or Semi-Quantitative) Using Computer-Assisted Technology Per Specimen; Each Multiplex Probe Stain Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88371. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88371 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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