Home / Medicare fees / 88738

88738 Hgb quant transcutaneous

What 88738 is

CMS fee schedule short descriptor: Hgb quant transcutaneous.

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 88738 (CY2026)

This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 88738 at 1 unit 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: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 88738? These codes are bundled into it

88738 is a Column 1 code in 3 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
88740Transcutaneous carboxyhb1 - modifier may bypassCheck pair
88741Transcutaneous methb1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

88738 is bundled into these codes

88738 appears as a Column 2 code in 6 active edits. Reported with one of these Column 1 codes on the same date of service, 88738 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0061U0Check pair
85013Spun microhematocrit0Check pair
85014Hematocrit0Check pair
85018Hemoglobin0Check pair
85025Complete cbc w/auto diff wbc1Check pair
85027Complete cbc automated1Check 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.