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See a sample rate comparisonCPT 88720 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.
Blood Test For Bilirubin, Bilirubin Is A Byproduct Created When Red Blood Cells Break Down. Tests Measure All Bilirubin Or The Amount Absorbed Into The Liver And Assess Liver And Gall Bladder Function.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures In Vivo (eg, Transcutaneous) Laboratory Procedures |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $5.02 national lab fee schedule rate (2026) · View Medicare rates for 88720 |
| Medicaid Fee Schedule | $5.02 median of the 8 states in the free preview · View Medicaid rates for 88720 |
National average reimbursement for CPT 88720 by major payers:
$4.58
$4.87
$6.39
$28.40
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CPT 88720
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$12.12Published rateSharron Acosta M.D.P.A.
Sharron Acosta, M.D., P.A.
$7.90Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$5.02Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$3.01Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$2.25Published rate
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See a sample payer proposalCPT 88720 vs. Other In Vivo (eg, Transcutaneous) Laboratory Procedures Codes
The CPT 88720 code is part of the Pathology and Laboratory Procedures services used for In Vivo (eg, Transcutaneous) Laboratory 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 88720 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 |
|---|---|---|
| 88720-CPT | Low | Blood Test For Bilirubin, Bilirubin Is A Byproduct Created When Red Blood Cells Break Down. Tests Measure All Bilirubin Or The Amount Absorbed Into The Liver And Assess Liver And Gall Bladder Function. |
| 88738-CPT | Low | Blood Oxygen Capacity Test, Blood Or Urine Is Tested For Hemoglobin (Hb) A Protein That Carries Oxygen In Red Blood Cells. Excessive Amounts Of The Various Types Of Hb Are Linked To Anemia And Premature Cell Death. |
| 88740-CPT | Low | Carbon Monoxide Blood Test, This Test Measures The Amount Of Carbon Monoxide (Co) Present In A Blood Sample. The Test Is Given To Individuals Suspected To Have Co Poisoning. |
| 88741-CPT | Low | Blood Test Methemoglobin, This Test Checks For Methemoglobin In The Blood. Methemoglobin Cuts Off Oxygen To Blood Cells And A Common Symptom Is A Bluish Skin Color. The Condition May Be Genetic Or Caused By Exposure To Chemicals. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88720 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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