88321 Consltj&reprt sld prep elswr
What 88321 is
CMS fee schedule short descriptor: Consltj&reprt sld prep elswr.
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 88321 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 1.59 | 1.15 | 0.07 | 2.81 | $93.86 |
| Facility (hospital, ASC) | 1.59 | 0.36 | 0.07 | 2.02 | $67.47 |
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 88321 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 88321? These codes are bundled into it
88321 is a Column 1 code in 62 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 | |
|---|---|---|---|
0009U | 1 - modifier may bypass | Check pair | |
0086U | 1 - modifier may bypass | Check pair | |
0140U | 1 - modifier may bypass | Check pair | |
0141U | 1 - modifier may bypass | Check pair | |
0142U | 1 - modifier may bypass | Check pair | |
0321U | 1 - modifier may bypass | Check pair | |
0441U | 1 - modifier may bypass | Check pair | |
0483U | 1 - modifier may bypass | Check pair | |
0484U | 1 - modifier may bypass | Check pair | |
0504U | 1 - modifier may bypass | Check pair | |
80503 | Path clin consltj sf 5-20 | 0 - no modifier bypass | Check pair |
80504 | Path clin consltj mod 21-40 | 0 - no modifier bypass | Check pair |
80505 | Path clin consltj high 41-60 | 0 - no modifier bypass | Check pair |
85097 | Bone marrow interpretation | 1 - modifier may bypass | Check pair |
87209 | Smear complex stain | 1 - modifier may bypass | Check pair |
88104 | Cytopath fl nongyn smears | 1 - modifier may bypass | Check pair |
88106 | Cytopath fl nongyn filter | 1 - modifier may bypass | Check pair |
88108 | Cytopath concentrate tech | 1 - modifier may bypass | Check pair |
88120 | Cytp urne 3-5 probes ea spec | 1 - modifier may bypass | Check pair |
88121 | Cytp urine 3-5 probes cmptr | 1 - modifier may bypass | Check pair |
88125 | Forensic cytopathology | 1 - modifier may bypass | Check pair |
88130 | Sex chromatin identification | 1 - modifier may bypass | Check pair |
88140 | Sex chromatin identification | 1 - modifier may bypass | Check pair |
88141 | Cytopath c/v interpret | 1 - modifier may bypass | Check pair |
88160 | Cytopath smear other source | 1 - modifier may bypass | Check pair |
88161 | Cytopath smear other source | 1 - modifier may bypass | Check pair |
88162 | Cytopath smear other source | 1 - modifier may bypass | Check pair |
88173 | Cytopath eval fna report | 1 - modifier may bypass | Check pair |
88182 | Cell marker study | 1 - modifier may bypass | Check pair |
88184 | Flowcytometry/ tc 1 marker | 1 - modifier may bypass | Check pair |
Showing 30 of 62 column 2 codes. Use the pair checker for any specific combination.
88321 is bundled into these codes
88321 appears as a Column 2 code in 3 active edits. Reported with one of these Column 1 codes on the same date of service, 88321 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
88323 | Consltj&reprt matrl prep sld | 0 | Check pair |
88325 | Consltj compre rvw rec reprt | 0 | Check pair |
G0416 | Prostate biopsy, any mthd | 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.