How much does Medicare pay for CPT 88360?

Medicare allowed an average of $59.67 per service and paid $47.34 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $266.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 88360?

Microscopic genetic analysis of tumor, manual. It was billed 682,151 times to 317,414 Medicare beneficiaries by 5,559 providers in 2024.

Does 88360 pay differently in an office than a hospital?

Yes. The allowed amount averaged $89.78 in an office setting and $40.38 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 88360 most?

Pathology, with 458,538 services from 5,321 clinicians. Next are Clinical Laboratory, Dermatology, Gastroenterology.

CPT 88360

Microscopic genetic analysis of tumor, manual

$59.67Medicare-allowed amount per service, averaged across 682,151 services

Providers submitted

$266.35

Asking price, not received

Medicare allowed

$59.67

The fee schedule figure

Medicare paid

$47.34

Balance is patient coinsurance

Providers submitted an average of $266.35 for this code and Medicare allowed $59.67 — 4.5× 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 $47.34 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $89.78
Hospital / facility: $40.38

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. 266,396 services were billed in an office setting and 415,755 in a facility.

Services: 682,151
Beneficiaries: 317,414
Providers billing it: 5,559
Total allowed: $40,703,950

What Medicare pays for CPT 88360

Across 682,151 services billed by 5,559 providers to 317,414 beneficiaries, Medicare allowed an average of $59.67 per service. That is 2.1 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 88360

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	458,538	214,433	$46.70	5,321
Clinical Laboratory	212,898	100,094	$84.78	185
Dermatology	7,621	1,151	$135.65	17
Gastroenterology	1,044	685	$112.83	9
General Practice	523	199	$40.16	1
Urology	412	375	$53.74	10
Undefined Physician type	385	98	$46.71	1
Hematology	305	169	$41.47	5
Diagnostic Radiology	131	60	$39.10	4
Hematology-Oncology	70	39	$39.35	1
Family Practice	68	26	$39.16	1
Pain Management	52	26	$41.26	1
Emergency Medicine	48	26	$40.98	1
Anesthesiology	35	19	$39.58	1
Ophthalmology	21	14	$42.51	1

88360 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
Arizona	110,982	$84.12	$68.25	128
California	98,047	$70.47	$48.71	590
New York	47,088	$58.94	$42.08	431
Texas	43,328	$51.23	$40.91	406
Florida	42,382	$58.06	$46.41	308
Illinois	38,918	$61.04	$46.55	265
Massachusetts	28,945	$53.97	$42.24	276
Pennsylvania	24,646	$41.02	$32.22	311
Ohio	16,712	$39.70	$32.37	241
New Jersey	16,572	$61.19	$43.59	141
Washington	15,279	$52.51	$39.90	133
Tennessee	13,675	$53.21	$44.70	152
Virginia	13,664	$43.61	$34.37	114
North Carolina	12,793	$50.06	$40.97	115
Maryland	12,469	$62.39	$45.81	105
Wisconsin	10,186	$41.73	$33.50	129
Missouri	9,586	$41.07	$32.92	131
Michigan	9,172	$41.03	$32.61	153
Indiana	8,840	$40.33	$32.97	114
Colorado	8,227	$46.76	$36.23	90
Connecticut	7,999	$54.94	$40.99	100
Kentucky	6,938	$41.81	$34.20	70
Minnesota	6,620	$48.05	$37.62	114
Georgia	6,116	$45.05	$36.48	86
Iowa	6,113	$54.70	$45.04	69
Kansas	5,736	$48.49	$39.87	60
South Carolina	5,407	$41.36	$33.60	65
Oklahoma	5,181	$42.37	$34.79	41
Oregon	5,146	$53.22	$41.60	63
Alabama	4,583	$56.73	$48.28	50
Utah	3,383	$67.30	$56.55	41
Nebraska	3,318	$50.97	$42.09	46
New Hampshire	2,970	$43.39	$33.65	44
Maine	2,747	$39.29	$31.12	31
Arkansas	2,609	$64.50	$55.66	37
Nevada	2,448	$61.73	$49.27	23
Montana	2,443	$39.34	$31.92	18
Delaware	2,368	$41.29	$32.76	22
Louisiana	2,268	$39.52	$32.95	34
New Mexico	2,111	$68.62	$57.50	20
Rhode Island	1,850	$40.75	$31.20	27
District of Columbia	1,798	$42.57	$31.12	24
Mississippi	1,757	$43.93	$36.81	25
North Dakota	1,748	$39.18	$30.76	22
South Dakota	1,726	$39.44	$30.99	14
Idaho	1,310	$38.43	$31.23	16
Hawaii	1,086	$57.37	$42.73	13
West Virginia	1,063	$40.18	$32.08	27
Alaska	924	$54.28	$31.79	10
Vermont	798	$38.99	$30.72	12
ZZ	44	$43.19	$31.30	1
Wyoming	32	$39.20	$28.37	1

Related codes

88305Pathology examination of tissue$50.75
88341Special stained specimen slides to examine tissue$40.33
88342Special stained specimen slides to examine tissue$58.61
88313Special stained specimen slides to examine tissue including interpreta$43.56
88312Special stained specimen slides to identify organisms including interp$75.82
88307Pathology examination of tissue$84.93
88304Pathology examination of tissue$21.25
88311Preparation of tissue for examination by removing any calcium present$12.68
88331Pathology examination of specimen during surgery$72.30
88350Antibody evaluation$59.99
88344Special stained specimen slides to examine tissue$100.56
88374Microscopic genetic analysis of tissue$108.04

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.