CPT code 88104: Fluid cytology, direct smear method2026 Medicare rate & RVUs
Reports cytologic examination and interpretation of direct smears made from non-gynecologic fluids, washings, or brushings, such as pleural fluid or bronchial washings.
Medicare pays $84.17 for 88104 nationally in the office. Local office rates run $74.55–$114.37.
Medicare rate · 88104
Fluid cytology, direct smear method
- Work RVUs
- 0.55
- Total RVUs
- 2.52
- Global days
- XXX
National rate · 2026
$84.17
Office setting, before claim adjustments.
See every locality for 88104 →Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 10 sections
What 88104 covers
This service covers cytologic examination of direct smears prepared from non-gynecologic fluids, washings, or brushings. Examples include pleural or peritoneal fluid, cerebrospinal fluid, and bronchial washings or brushings. Laboratory staff prepare and stain the slides, and a cytopathologist or other qualified physician examines the cells and provides the interpretation. The findings may help evaluate a specimen for malignant or other abnormal cells.
Choose this code when the specimen is examined as a smear rather than processed by a filtration, concentration, or cellular-enhancement method. The report should identify the specimen source and include the cytologic findings and physician interpretation. Medicare recognizes professional and technical components: modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff work. Reporting without either modifier represents the combined service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 88104 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$74.55 to $114.37
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $75.64 | Unavailable |
| Alaska | $97.12 | Unavailable |
| Arizona | $82.02 | Unavailable |
| Arkansas | $74.55 | Unavailable |
| Atlanta, GA | $85.46 | Unavailable |
| Austin, TX | $87.85 | Unavailable |
| Bakersfield, CA | $90.35 | Unavailable |
| Baltimore area, MD | $89.43 | Unavailable |
| Beaumont, TX | $78.27 | Unavailable |
| Brazoria, TX | $83.51 | Unavailable |
| Chicago, IL | $85.92 | Unavailable |
| Chico, CA | $90.24 | Unavailable |
| Colorado | $88.32 | Unavailable |
| Connecticut | $89.74 | Unavailable |
| Dallas, TX | $83.93 | Unavailable |
| Delaware | $83.38 | Unavailable |
| Detroit, MI | $82.59 | Unavailable |
| East St. Louis, IL | $80.00 | Unavailable |
| El Centro, CA | $90.24 | Unavailable |
| Fort Lauderdale, FL | $85.82 | Unavailable |
| Fort Worth, TX | $83.30 | Unavailable |
| Fresno, CA | $90.24 | Unavailable |
| Galveston, TX | $83.69 | Unavailable |
| Hanford, CA | $90.24 | Unavailable |
| Hawaii, Guam, HI | $92.63 | Unavailable |
| Houston, TX | $84.24 | Unavailable |
| Idaho | $78.46 | Unavailable |
| Indiana | $78.92 | Unavailable |
| Iowa | $78.06 | Unavailable |
| Kansas | $77.45 | Unavailable |
| Kentucky | $76.89 | Unavailable |
| King County, WA | $99.61 | Unavailable |
| Los Angeles, CA | $96.44 | Unavailable |
| Madera, CA | $90.24 | Unavailable |
| Manhattan, NY | $96.43 | Unavailable |
| Marin County, CA | $111.94 | Unavailable |
| Merced, CA | $90.24 | Unavailable |
| Metropolitan Boston, MA | $97.38 | Unavailable |
| Metropolitan Kansas City, MO | $80.19 | Unavailable |
| Metropolitan Philadelphia, PA | $87.35 | Unavailable |
| Metropolitan St. Louis, MO | $81.06 | Unavailable |
| Miami, FL | $88.36 | Unavailable |
| Minnesota | $85.34 | Unavailable |
| Mississippi | $74.90 | Unavailable |
| Modesto, CA | $90.24 | Unavailable |
| Montana | $84.17 | Unavailable |
| Napa, CA | $105.44 | Unavailable |
| Nebraska | $78.56 | Unavailable |
| Nevada | $84.07 | Unavailable |
| New Hampshire | $86.70 | Unavailable |
| New Mexico | $78.99 | Unavailable |
| New Orleans, LA | $80.48 | Unavailable |
| North Carolina | $79.47 | Unavailable |
| North Dakota | $83.58 | Unavailable |
| Northern New Jersey | $95.76 | Unavailable |
| NYC suburbs and Long Island, NY | $98.45 | Unavailable |
| Ohio | $78.54 | Unavailable |
| Oklahoma | $77.01 | Unavailable |
| Oxnard, CA | $96.10 | Unavailable |
| Portland, OR | $91.40 | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | $91.36 | Unavailable |
| Puerto Rico | $84.87 | Unavailable |
| Queens, NY | $97.58 | Unavailable |
| Redding, CA | $90.24 | Unavailable |
| Rest of California | $90.24 | Unavailable |
| Rest of Florida | $81.82 | Unavailable |
| Rest of Georgia | $77.36 | Unavailable |
| Rest of Illinois | $79.10 | Unavailable |
| Rest of Louisiana | $76.68 | Unavailable |
| Rest of Maine | $78.61 | Unavailable |
| Rest of Maryland | $85.05 | Unavailable |
| Rest of Massachusetts | $87.70 | Unavailable |
| Rest of Michigan | $78.66 | Unavailable |
| Rest of Missouri | $75.20 | Unavailable |
| Rest of New Jersey | $90.96 | Unavailable |
| Rest of New York | $80.63 | Unavailable |
| Rest of Oregon | $83.61 | Unavailable |
| Rest of Pennsylvania | $78.80 | Unavailable |
| Rest of Texas | $80.77 | Unavailable |
| Rest of Washington | $87.60 | Unavailable |
| Rhode Island | $86.55 | Unavailable |
| Riverside, CA | $90.57 | Unavailable |
| Sacramento, CA | $94.93 | Unavailable |
| Salinas, CA | $94.58 | Unavailable |
| San Benito County, CA | $114.37 | Unavailable |
| San Diego, CA | $96.96 | Unavailable |
| San Francisco, CA | $111.91 | Unavailable |
| San Luis Obispo, CA | $93.02 | Unavailable |
| Santa Clara County, CA | $114.23 | Unavailable |
| Santa Cruz, CA | $98.02 | Unavailable |
| Santa Maria, CA | $94.98 | Unavailable |
| Santa Rosa, CA | $99.03 | Unavailable |
| South Carolina | $79.10 | Unavailable |
| South Dakota | $83.50 | Unavailable |
| Southern Maine, ME | $83.22 | Unavailable |
| Stockton, CA | $90.24 | Unavailable |
| Suburban Chicago, IL | $86.82 | Unavailable |
| Tennessee | $77.81 | Unavailable |
| Utah | $80.18 | Unavailable |
| Vallejo, CA | $105.39 | Unavailable |
| Vermont | $83.03 | Unavailable |
| Virgin Islands, VI | $84.87 | Unavailable |
| Virginia | $82.77 | Unavailable |
| Visalia, CA | $90.24 | Unavailable |
| Washington, DC area | $96.81 | Unavailable |
| West Virginia | $76.11 | Unavailable |
| Wisconsin | $80.76 | Unavailable |
| Wyoming | $83.91 | Unavailable |
| Yuba City, CA | $90.24 | Unavailable |
88104 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$74.55
$102.31
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $97.12 | 1 |
| AL | $75.64 | 1 |
| AR | $74.55 | 1 |
| AZ | $82.02 | 1 |
| CA | $90.24–$114.37 | 29 |
| CO | $88.32 | 1 |
| CT | $89.74 | 1 |
| DC | $96.81 | 1 |
| DE | $83.38 | 1 |
| FL | $81.82–$88.36 | 3 |
| GA | $77.36–$85.46 | 2 |
| GU | $92.63 | 1 |
| HI | $92.63 | 1 |
| IA | $78.06 | 1 |
| ID | $78.46 | 1 |
| IL | $79.10–$86.82 | 4 |
| IN | $78.92 | 1 |
| KS | $77.45 | 1 |
| KY | $76.89 | 1 |
| LA | $76.68–$80.48 | 2 |
| MA | $87.70–$97.38 | 2 |
| MD | $85.05–$96.81 | 3 |
| ME | $78.61–$83.22 | 2 |
| MI | $78.66–$82.59 | 2 |
| MN | $85.34 | 1 |
| MO | $75.20–$81.06 | 3 |
| MS | $74.90 | 1 |
| MT | $84.17 | 1 |
| NC | $79.47 | 1 |
| ND | $83.58 | 1 |
| NE | $78.56 | 1 |
| NH | $86.70 | 1 |
| NJ | $90.96–$95.76 | 2 |
| NM | $78.99 | 1 |
| NV | $84.07 | 1 |
| NY | $80.63–$98.45 | 5 |
| OH | $78.54 | 1 |
| OK | $77.01 | 1 |
| OR | $83.61–$91.40 | 2 |
| PA | $78.80–$87.35 | 2 |
| PR | $84.87 | 1 |
| RI | $86.55 | 1 |
| SC | $79.10 | 1 |
| SD | $83.50 | 1 |
| TN | $77.81 | 1 |
| TX | $78.27–$87.85 | 8 |
| UT | $80.18 | 1 |
| VA | $82.77–$96.81 | 2 |
| VI | $84.87 | 1 |
| VT | $83.03 | 1 |
| WA | $87.60–$99.61 | 2 |
| WI | $80.76 | 1 |
| WV | $76.11 | 1 |
| WY | $83.91 | 1 |
How the 88104 rate is calculated
Each of 88104’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 88104
RVUs × geographic indexes × conversion factor
Work0.55
0.55 RVUs× 1.000 GPCI
Practice expense1.94
1.94 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
2.5200
Conversion factor
$33.4009
Medicare rate
$84.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 88104
The CMS indicators that decide how 88104 is paid alongside other services.
CMS payment indicators · 88104
Fluid cytology, direct smear method
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
88104 without 26 · national office
$84.17
Fluid cytology, direct smear method
88104-26 · Professional component
$26.72
Pays only the interpretation and report.
88104 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 88106Fluid cytologyFilter technique
- 88104 is for direct smears. Choose 88106 when the non-gynecologic specimen is prepared using filtration.
- 88108Concentrated cytologyNon-gynecologic specimen
- 88104 covers direct-smear preparation; 88108 is used when a concentration technique is used to prepare the specimen.
- 88112Selective-enhancement cytologyNongynecologic specimens
- Use 88112 for a non-gynecologic specimen prepared with a selective cellular-enhancement method, rather than as a direct smear.
88104 billing questions
When should 88104 be chosen instead of 88108?
Use 88104 for a direct smear of a non-gynecologic fluid, washing, or brushing. Use 88108 when the specimen is processed using a concentration technique.
Does 88104 include the physician's interpretation?
Yes. The service includes interpretation; modifier 26 reports the professional component alone, while modifier TC reports the technical component alone.
What does the technical component cover?
The technical component represents the equipment and staff work involved in the service. Modifier TC identifies that portion.
Can 88104 be reported for a cervical or vaginal smear?
No. This code is for non-gynecologic fluid, washing, or brushing smears; cervical and vaginal cytology uses the applicable gynecologic cytopathology code.
What specimen details should the report include?
Document the source and type of specimen, the smear preparation, and the cytologic findings with the physician's interpretation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 88104 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist