CPT 88372 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 20 - Urgent Care Facility 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 88372 |
| Medicaid Fee Schedule | View Medicaid rates for 88372 |
National average reimbursement for CPT 88372 by major payers:
$28.79
$29.95
$27.18
$37.29
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 88372 | $19.93 | 1972071991 - GAINESVILLE COMMUNITY HOSPITAL, INC., NORTH TEXAS MEDICAL CENTER | 831683025 - (TX) GAINESVILLE COMMUNITY HOSPITAL INC | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $16.85 | 1174576698 - CHCA BAYSHORE LP, BAYSHORE MEDICAL CENTER | 621801359 | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $16.85 | 1295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM | 752796815 - CHRISTUS HEALTH ARK-LA-TEX | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $19.32 | 1013212448 - GUSTAVO DELGADO | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $15.72 | 1649223645 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, ROUND ROCK MEDICAL CENTER | 743001674 - (TX) LONE STAR CIRCLE OF CARE | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $26.21 | 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 | 88372 | $15.72 | 1104830900 - VAL VERDE HOSPITAL CORPORATION, VAL VERDE REGIONAL MEDICAL CENTER | 742941598 - VAL VERDE HOSPITAL CORPORATION | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $18.97 | 1699768705 - GONZALES HEALTHCARE SYSTEMS | 741625013 | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $33.22 | 1801825005 - HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH, LASALLE GENERAL HOSPITAL | 720690217 - (LA) HOSPITAL SERVICE DISTRICT 2 OF LASALLE PARISH | LA | General Acute Care Hospital (282N00000X) |
United | 88372 | $15.72 | 1407191984 - BSA HOSPITAL LLC | 300754305 | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $15.72 | 1407191984 - BSA HOSPITAL LLC | 900914340 | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $19.32 | 1316936990 - EL PASO COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER OF EL PASO | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $26.21 | 1457994188 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MICRO-HOSPITAL WESLACO | 452662980 | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $11.47 | 1104830900 - VAL VERDE HOSPITAL CORPORATION, VAL VERDE REGIONAL MEDICAL CENTER | 742941598 - VAL VERDE HOSPITAL CORPORATION | TX | General Acute Care Hospital (282N00000X) |
United | 88372 | $41.11 | 1174572416 - DALLAS VAMC | 756108647 | 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 88372 vs. Other Surgical Pathology Procedures Codes
The CPT 88372 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 88372 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 | Analysis Of Tissue Protein, This Test Detects Specific Proteins In A Sample Of Tissue. Analysis Of Specific Proteins Is Used To Help Diagnose Certain Diseases. |
| 88372-CPT | Low | Analysis Of Tissue Protein, This Test Detects Specific Proteins In A Sample Of Tissue. Analysis Of Specific Proteins Is Used To Help Diagnose Certain Diseases. |
| 88373-CPT | Low | M Phmtrc Alys Ishquant Semiq, 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 | M Phmtrc Alys Ishquant Semiq, 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 88372. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88372 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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