88368 Insitu hybridization manual
What 88368 is
CMS fee schedule short descriptor: Insitu hybridization manual.
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 88368 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.86 | 3.48 | 0.03 | 4.37 | $145.96 |
| Facility (hospital, ASC) | 0.86 | 3.48 | 0.03 | 4.37 | $145.96 |
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 88368 at 3 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 88368? These codes are bundled into it
88368 is a Column 1 code in 15 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 | |
|---|---|---|---|
80503 | Path clin consltj sf 5-20 | 1 - modifier may bypass | Check pair |
80504 | Path clin consltj mod 21-40 | 1 - modifier may bypass | Check pair |
80505 | Path clin consltj high 41-60 | 1 - modifier may bypass | Check pair |
80506 | Path clin consltj prolng svc | 1 - modifier may bypass | Check pair |
88271 | Cytogenetics dna probe | 1 - modifier may bypass | Check pair |
88272 | Cytogenetics 3-5 | 1 - modifier may bypass | Check pair |
88273 | Cytogenetics 10-30 | 1 - modifier may bypass | Check pair |
88274 | Cytogenetics 25-99 | 1 - modifier may bypass | Check pair |
88275 | Cytogenetics 100-300 | 1 - modifier may bypass | Check pair |
88346 | Imfluor 1st 1antb stain px | 1 - modifier may bypass | Check pair |
88358 | Analysis tumor | 1 - modifier may bypass | Check pair |
88365 | Insitu hybridization (fish) | 1 - modifier may bypass | Check pair |
88380 | Microdissection laser | 1 - modifier may bypass | Check pair |
88381 | Microdissection manual | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
88368 is bundled into these codes
88368 appears as a Column 2 code in 467 active edits. Reported with one of these Column 1 codes on the same date of service, 88368 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0001U | 1 | Check pair | |
0004M | 1 | Check pair | |
0005U | 1 | Check pair | |
0006M | 1 | Check pair | |
0007M | 1 | Check pair | |
0007U | 1 | Check pair | |
0008U | 1 | Check pair | |
0009U | 1 | Check pair | |
0010U | 1 | Check pair | |
0011M | 1 | Check pair | |
0012M | 1 | Check pair | |
0013M | 1 | Check pair | |
0016M | 1 | Check pair | |
0016U | 1 | Check pair | |
0017U | 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.