How much does Medicare pay for CPT 88369?

Medicare allowed an average of $78.63 per service and paid $62.70 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $306.44, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 88369?

Microscopic genetic analysis of tissue, manual, each additional procedure. It was billed 13,470 times to 7,635 Medicare beneficiaries by 132 providers in 2024.

Does 88369 pay differently in an office than a hospital?

Yes. The allowed amount averaged $117.00 in an office setting and $32.79 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 88369 most?

Pathology, with 8,722 services from 114 clinicians. Next are Clinical Laboratory, Pediatric Medicine, Hematology-Oncology.

CPT 88369

Microscopic genetic analysis of tissue, manual, each additional procedure

$78.63Medicare-allowed amount per service, averaged across 13,470 services

Providers submitted

$306.44

Asking price, not received

Medicare allowed

$78.63

The fee schedule figure

Medicare paid

$62.70

Balance is patient coinsurance

Providers submitted an average of $306.44 for this code and Medicare allowed $78.63 — 3.9× 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 $62.70 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $117.00
Hospital / facility: $32.79

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. 7,333 services were billed in an office setting and 6,137 in a facility.

Services: 13,470
Beneficiaries: 7,635
Providers billing it: 132
Total allowed: $1,059,146

What Medicare pays for CPT 88369

Across 13,470 services billed by 132 providers to 7,635 beneficiaries, Medicare allowed an average of $78.63 per service. That is 1.8 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 88369

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	8,722	4,827	$62.62	114
Clinical Laboratory	4,407	2,617	$113.09	14
Pediatric Medicine	182	65	$34.12	1
Hematology-Oncology	94	87	$31.89	1
Dermatology	33	22	$133.56	1
Hematology	32	17	$31.16	1

88369 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
New York	4,160	$115.85	$78.52	12
Texas	1,548	$71.77	$58.37	11
California	1,369	$72.83	$49.61	15
Connecticut	1,175	$135.45	$100.30	1
Virginia	893	$34.31	$27.75	10
Kansas	638	$30.90	$25.21	8
Georgia	435	$34.67	$26.93	6
Missouri	384	$31.53	$25.13	8
Illinois	379	$98.47	$75.93	6
Florida	333	$32.06	$25.24	7
Oregon	312	$33.97	$24.93	8
Tennessee	311	$31.53	$25.18	7
Minnesota	268	$31.71	$25.23	1
Massachusetts	242	$33.20	$25.44	2
Arizona	228	$42.92	$34.34	7
New Jersey	214	$66.87	$47.13	3
Michigan	191	$34.18	$25.25	1
South Carolina	70	$32.37	$25.07	1
Rhode Island	54	$32.53	$25.23	2
Nevada	54	$64.64	$51.56	3
Wisconsin	44	$31.34	$25.22	3
New Mexico	31	$32.12	$25.23	2
Indiana	30	$32.37	$25.24	1
Maryland	22	$31.72	$25.31	1
Louisiana	18	$31.37	$25.20	1
Kentucky	15	$30.70	$25.31	1
Ohio	14	$31.17	$25.22	1
Nebraska	13	$30.74	$25.26	1
Idaho	13	$31.18	$25.19	1
North Carolina	12	$30.95	$23.23	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
88360Microscopic genetic analysis of tumor$59.67
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

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.