How much does Medicare pay for CPT 88173?

Medicare allowed an average of $83.18 per service and paid $65.15 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $280.58, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 88173?

Evaluation of fine needle aspirate with interpretation and report. It was billed 342,543 times to 229,202 Medicare beneficiaries by 4,283 providers in 2024.

Does 88173 pay differently in an office than a hospital?

Yes. The allowed amount averaged $141.44 in an office setting and $67.10 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 88173 most?

Pathology, with 293,819 services from 4,089 clinicians. Next are Clinical Laboratory, Diagnostic Radiology, Pain Management.

CPT 88173

Evaluation of fine needle aspirate with interpretation and report

$83.18Medicare-allowed amount per service, averaged across 342,543 services

Providers submitted

$280.58

Asking price, not received

Medicare allowed

$83.18

The fee schedule figure

Medicare paid

$65.15

Balance is patient coinsurance

Providers submitted an average of $280.58 for this code and Medicare allowed $83.18 — 3.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $65.15 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $141.44
Hospital / facility: $67.10

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 74,097 services were billed in an office setting and 268,446 in a facility.

Services: 342,543
Beneficiaries: 229,202
Providers billing it: 4,283
Total allowed: $28,492,727

What Medicare pays for CPT 88173

Across 342,543 services billed by 4,283 providers to 229,202 beneficiaries, Medicare allowed an average of $83.18 per service. That is 1.5 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 88173

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	293,819	194,679	$74.12	4,089
Clinical Laboratory	47,909	33,938	$138.83	179
Diagnostic Radiology	290	182	$64.06	4
Pain Management	158	124	$69.98	1
Gastroenterology	71	52	$101.77	1
Endocrinology	62	35	$137.97	2
Emergency Medicine	56	47	$68.90	1
Obstetrics & Gynecology	47	45	$85.53	1
Dermatology	43	31	$66.46	1
Anesthesiology	40	28	$66.77	1
Ophthalmology	18	17	$65.08	1
General Surgery	16	13	$103.48	1
Hematology	14	11	$74.87	1

88173 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	42,188	$112.96	$81.82	365
New York	30,669	$122.13	$85.29	244
Florida	20,273	$79.77	$63.50	277
Texas	19,815	$75.96	$60.04	297
Pennsylvania	16,457	$68.21	$52.69	221
Illinois	15,596	$68.78	$53.35	214
Ohio	11,768	$68.61	$55.64	196
Massachusetts	11,507	$72.85	$53.64	157
Tennessee	10,372	$82.25	$68.45	116
North Carolina	10,061	$72.88	$59.15	121
New Jersey	8,905	$83.43	$60.25	120
Michigan	8,246	$66.97	$52.93	139
Indiana	8,109	$73.40	$60.36	101
Maryland	7,778	$76.34	$57.08	79
Virginia	7,542	$75.88	$59.01	96
Arizona	7,506	$84.70	$67.49	91
Georgia	7,366	$76.94	$60.83	116
Washington	6,960	$74.01	$55.82	97
South Carolina	6,809	$68.34	$56.09	76
Wisconsin	6,444	$67.59	$53.44	72
Minnesota	6,128	$71.14	$54.80	94
Missouri	5,995	$66.16	$52.72	91
Kentucky	5,246	$66.44	$54.58	62
Connecticut	4,925	$91.68	$67.12	66
Colorado	4,697	$69.74	$53.57	78
Louisiana	4,195	$66.98	$54.96	59
Kansas	3,832	$70.31	$56.49	43
Iowa	3,698	$67.98	$54.68	57
Oklahoma	3,668	$79.58	$66.21	30
Nebraska	2,982	$70.18	$57.01	33
Alabama	2,596	$74.40	$61.42	49
Delaware	2,567	$83.18	$65.22	19
Nevada	2,551	$89.98	$73.69	23
Arkansas	2,406	$82.37	$68.97	31
Mississippi	2,316	$67.34	$55.32	37
New Hampshire	2,030	$67.97	$52.38	23
Oregon	1,980	$84.94	$65.52	29
Utah	1,891	$80.82	$66.96	35
District of Columbia	1,721	$82.92	$58.76	14
West Virginia	1,635	$74.21	$60.00	34
South Dakota	1,606	$66.62	$52.92	20
Maine	1,455	$67.40	$52.08	19
Montana	1,316	$69.77	$55.21	19
North Dakota	1,221	$65.80	$51.44	20
New Mexico	1,165	$70.71	$57.03	25
Rhode Island	1,035	$67.14	$51.46	14
Vermont	1,022	$65.50	$50.85	15
Hawaii	905	$78.69	$56.61	16
Alaska	584	$87.65	$54.19	10
Idaho	426	$67.81	$55.21	12
Puerto Rico	244	$97.68	$77.50	8
Wyoming	134	$66.50	$51.21	3

Related codes

88185Flow cytometry technique for dna or cell analysis$24.39
88112Cell examination of specimen$38.46
88189Flow cytometry technique for dna or cell analysis$82.33
88108Cell examination of specimen$28.49
88175Pap test, automated thin layer preparation; automated system and manua$25.99
88172Evaluation of fine needle aspirate$36.27
88184Flow cytometry technique for dna or cell analysis$81.32
88120Cell examination of urine$465.04
88188Flow cytometry technique for dna or cell analysis$60.36
88177Pap test, evaluation of fine needle aspirate, immediate, each addition$21.33
88141Pap test$24.26
88121Cell examination of urine$380.49

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.