How much does Medicare pay for CPT 88738?

Medicare allowed an average of $4.90 per service and paid $4.90 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $20.38, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 88738?

Hemoglobin measurement. It was billed 9,943 times to 8,937 Medicare beneficiaries by 117 providers in 2024.

Which specialty bills 88738 most?

Pulmonary Disease, with 7,880 services from 84 clinicians. Next are Internal Medicine, Critical Care (Intensivists), Emergency Medicine.

CPT 88738

Hemoglobin measurement

$4.90Medicare-allowed amount per service, averaged across 9,943 services

Providers submitted

$20.38

Asking price, not received

Medicare allowed

$4.90

The fee schedule figure

Medicare paid

$4.90

Balance is patient coinsurance

Providers submitted an average of $20.38 for this code and Medicare allowed $4.90 — 4.2× 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 $4.90 (100%); the rest is the patient’s coinsurance and deductible.

Services: 9,943
Beneficiaries: 8,937
Providers billing it: 117
Total allowed: $48,721

What Medicare pays for CPT 88738

Across 9,943 services billed by 117 providers to 8,937 beneficiaries, Medicare allowed an average of $4.90 per service. 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 88738

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	7,880	7,282	$4.90	84
Internal Medicine	790	464	$4.91	12
Critical Care (Intensivists)	707	678	$4.91	8
Emergency Medicine	151	148	$4.82	2
Obstetrics & Gynecology	146	146	$4.92	4
Hospitalist	87	86	$4.92	1
Gynecological Oncology	76	40	$4.86	1
Allergy/ Immunology	56	50	$4.92	2
Gastroenterology	20	13	$4.92	1
Family Practice	17	17	$4.92	1
Nurse Practitioner	13	13	$4.59	1

88738 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	2,056	$4.92	$4.92	11
California	1,313	$4.91	$4.92	14
Pennsylvania	1,225	$4.90	$4.92	8
Alabama	1,062	$4.91	$4.92	5
Florida	975	$4.92	$4.92	12
Kentucky	864	$4.84	$4.92	12
New Jersey	499	$4.87	$4.92	6
Colorado	453	$4.91	$4.92	10
Wisconsin	279	$4.87	$4.92	4
Arizona	270	$4.90	$4.92	3
North Carolina	240	$4.90	$4.92	10
Michigan	198	$4.90	$4.92	10
Minnesota	183	$4.92	$4.92	3
Indiana	99	$4.92	$4.92	4
Oregon	76	$4.86	$4.92	1
Massachusetts	62	$4.92	$4.92	1
Tennessee	57	$4.92	$4.92	1
Oklahoma	20	$4.92	$4.92	1
West Virginia	12	$4.92	$4.92	1

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.