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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 RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)1.591.150.072.81$93.86
Facility (hospital, ASC)1.590.360.072.02$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.

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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 codeShort descriptionModifier indicator
0009U1 - modifier may bypassCheck pair
0086U1 - modifier may bypassCheck pair
0140U1 - modifier may bypassCheck pair
0141U1 - modifier may bypassCheck pair
0142U1 - modifier may bypassCheck pair
0321U1 - modifier may bypassCheck pair
0441U1 - modifier may bypassCheck pair
0483U1 - modifier may bypassCheck pair
0484U1 - modifier may bypassCheck pair
0504U1 - modifier may bypassCheck pair
80503Path clin consltj sf 5-200 - no modifier bypassCheck pair
80504Path clin consltj mod 21-400 - no modifier bypassCheck pair
80505Path clin consltj high 41-600 - no modifier bypassCheck pair
85097Bone marrow interpretation1 - modifier may bypassCheck pair
87209Smear complex stain1 - modifier may bypassCheck pair
88104Cytopath fl nongyn smears1 - modifier may bypassCheck pair
88106Cytopath fl nongyn filter1 - modifier may bypassCheck pair
88108Cytopath concentrate tech1 - modifier may bypassCheck pair
88120Cytp urne 3-5 probes ea spec1 - modifier may bypassCheck pair
88121Cytp urine 3-5 probes cmptr1 - modifier may bypassCheck pair
88125Forensic cytopathology1 - modifier may bypassCheck pair
88130Sex chromatin identification1 - modifier may bypassCheck pair
88140Sex chromatin identification1 - modifier may bypassCheck pair
88141Cytopath c/v interpret1 - modifier may bypassCheck pair
88160Cytopath smear other source1 - modifier may bypassCheck pair
88161Cytopath smear other source1 - modifier may bypassCheck pair
88162Cytopath smear other source1 - modifier may bypassCheck pair
88173Cytopath eval fna report1 - modifier may bypassCheck pair
88182Cell marker study1 - modifier may bypassCheck pair
88184Flowcytometry/ tc 1 marker1 - modifier may bypassCheck 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 codeShort descriptionModifier indicator
88323Consltj&reprt matrl prep sld0Check pair
88325Consltj compre rvw rec reprt0Check pair
G0416Prostate biopsy, any mthd1Check 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.