CPT code 88164: Pap screening, manual, Bethesda system2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Manual screening of cervical or vaginal cytology slides under the Bethesda System, reported for Pap testing performed under physician supervision.
Medicare pays $18.54 for 88164 under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$18.54
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- +22.6%
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 8 sections
What 88164 covers
88164 covers manual screening of cervical or vaginal cytology slides using the Bethesda System. Laboratory personnel perform the screening under physician supervision. The code is specific to cervical or vaginal slides, not cytology smears from other sources. Distinguish this service from cervical or vaginal methods coded for thin-layer preparation or automated screening.
Report 88164 for the manual Bethesda screening service. A physician’s interpretation, when separately performed and documented, may be reported with 88141. Medicare pays 88164 only through the CLFS at one national amount per code, with no locality or office/facility adjustment. The 2026 national CLFS amount is $18.54; the test has no physician fee schedule payment.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 88164
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 88164. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Excluded from the physician fee schedule
The physician fee schedule lists 88164 with status X (excluded by statute), so the test itself is paid only from the CLFS.
88164 on the lab fee schedule since 2020
88164 · CLFS 2026 Q4 (current)
$18.54
Up 22.6% from $15.12 in 2020
Every change on file
- Jan 1, 2026 · CLFS 2026 Q1$18.19 → $18.54 (+1.9%)
- Jan 1, 2025 · CLFS 2025 Q1$17.76 → $18.19 (+2.4%)
- Jan 1, 2024 · CLFS 2024 Q1$17.31 → $17.76 (+2.6%)
- Jan 1, 2023 · CLFS 2023 Q1$15.92 → $17.31 (+8.7%)
- Jan 1, 2022 · CLFS 2022 Q1$15.15 → $15.92 (+5.1%)
- Jan 1, 2021 · CLFS 2021 Q1$15.12 → $15.15 (+0.2%)
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
88164 compared with similar tests
- 88150Pap testManual slide screening$18.54
- Both are manual cervical or vaginal cytology slide-screening codes. Choose 88164 when the Bethesda System is used.
- 88142Pap testPreservative fluid, manual screening$20.26
- 88164 is manual screening using the Bethesda System; 88142 is associated with thin-layer preparation.
- 88147Pap testAutomated screening$50.56
- 88164 is manual screening using the Bethesda System. 88147 is for automated cervical or vaginal cytology screening.
- 88141Pap interpretationPhysician interpretation and report$21.72–$31.60
- 88164 is the screening service. 88141 represents physician interpretation reported as an add-on when separately performed.
88164 billing questions
When is 88164 appropriate instead of 88150?
Use 88164 when manual cervical or vaginal slide screening uses the Bethesda System. 88150 is another manual cervical or vaginal cytology screening code.
How does 88164 differ from 88142?
88164 is for manual screening using the Bethesda System. 88142 is associated with thin-layer preparation.
Can physician interpretation be reported separately?
88141 represents physician interpretation of cervical or vaginal cytology. It may be reported with 88164 when that interpretation is separately performed and documented.
What should the laboratory record support?
The record should support cervical or vaginal cytology slides, manual screening, and use of the Bethesda System.
How does Medicare pay 88164?
Medicare pays 88164 only through the CLFS at one national amount per code, without locality or office/facility adjustment.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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