88104 Cytopath fl nongyn smears
What 88104 is
CMS fee schedule short descriptor: Cytopath fl nongyn smears.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 88104 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.55 | 1.94 | 0.03 | 2.52 | $84.17 |
| Facility (hospital, ASC) | 0.55 | 1.94 | 0.03 | 2.52 | $84.17 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 88104 at 5 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 88104? These codes are bundled into it
88104 is a Column 1 code in 5 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
88106 | Cytopath fl nongyn filter | 1 - modifier may bypass | Check pair |
88172 | Cytp dx eval fna 1st ea site | 1 - modifier may bypass | Check pair |
88173 | Cytopath eval fna report | 1 - modifier may bypass | Check pair |
88387 | Macroscopic xm dsj&prep tiss | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
88104 is bundled into these codes
88104 appears as a Column 2 code in 11 active edits. Reported with one of these Column 1 codes on the same date of service, 88104 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
88108 | Cytopath concentrate tech | 1 | Check pair |
88112 | Cytopath cell enhance tech | 1 | Check pair |
88150 | Cytopath c/v manual | 1 | Check pair |
88155 | Cytopath c/v index add-on | 1 | Check pair |
88160 | Cytopath smear other source | 1 | Check pair |
88161 | Cytopath smear other source | 1 | Check pair |
88162 | Cytopath smear other source | 1 | Check pair |
88164 | Cytopath tbs c/v manual | 1 | Check pair |
88321 | Consltj&reprt sld prep elswr | 1 | Check pair |
88323 | Consltj&reprt matrl prep sld | 1 | Check pair |
88325 | Consltj compre rvw rec reprt | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.