CPT code 88120: Urine FISH, three to five probes2026 Medicare rate & RVUs in Missouri
Reports FISH analysis of a urinary tract specimen using three to five molecular probes, commonly to assess for urothelial carcinoma-associated chromosomal changes.
Medicare pays $472.87–$518.04 for 88120 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 88120 covers
This service uses fluorescent in situ hybridization to assess cells in a urinary tract specimen for chromosomal changes associated with urothelial carcinoma. It is commonly used in the evaluation or surveillance of patients with a history of bladder cancer, including when urine testing is used to look for evidence of recurrent disease. Laboratory personnel prepare and process the specimen; a pathologist interprets the findings. The code represents analysis with three to five probes for each specimen, rather than conventional microscopic urine cytology.
Report one unit for each specimen analyzed under the three-to-five-probe method. Documentation should identify the specimen, the FISH analysis performed, the probes or probe set used, and the interpreted result. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff work. Report without either modifier when billing the global service, which includes both components.
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 88120 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$472.87 to $518.04
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $511.48 | Unavailable |
| Metropolitan St. Louis, MO | $518.04 | Unavailable |
| Rest of Missouri | $472.87 | Unavailable |
How the 88120 rate is calculated
Each of 88120’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 · 88120
RVUs × geographic indexes × conversion factor
Work1.17
1.17 RVUs× 1.000 GPCI
Practice expense15.01
15.01 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
16.2300
Conversion factor
$33.4009
Medicare rate
$542.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 88120
The CMS indicators that decide how 88120 is paid alongside other services.
CMS payment indicators · 88120
Urine FISH, three to five probes
| 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
88120 without 26 · national office
$542.10
Urine FISH, three to five probes
88120-26 · Professional component
$54.44
Pays only the interpretation and report.
88120 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 88121Urine FISHComputer-assisted, 3–5 probes
- Both apply to urinary tract specimen FISH with three to five probes. The distinction is computer-assisted analysis under 88121 versus the method represented by 88120.
- 88112Selective-enhancement cytologyNongynecologic specimens
- 88112 reports cell-enhanced cytopathology preparation and examination. 88120 reports FISH probe analysis for chromosomal changes, not cell morphology alone.
- 88108Concentrated cytologyNon-gynecologic specimen
- 88108 is for cytopathology of a concentrated fluid specimen. 88120 is selected for urinary tract specimen FISH using three to five molecular probes.
88120 billing questions
How does 88120 differ from 88121?
Both describe urinary tract specimen FISH using three to five probes. 88121 is the related code for analysis using computer-assisted technology; select the code that matches the method documented.
Is this conventional urine cytology?
No. This code is for fluorescent in situ hybridization to detect chromosomal changes. Conventional cytology evaluates cell appearance and is reported with a different cytopathology code.
How many units are reported?
Report per specimen analyzed with the three-to-five-probe method. The probe count does not create a separate unit for each probe.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation alone and modifier TC for the technical work alone. An unmodified claim represents the global service, including both components.
What documentation supports the service?
Record the urinary tract specimen, the FISH method and probe set, the analysis performed, and the interpreted findings. The documentation should support that three to five probes were used for each specimen.
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.
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