CPT code 88172: FNA adequacy, first site2026 Medicare rate & RVUs in Puerto Rico
Reports immediate cytopathology review of fine needle aspirate material at the first site to assess specimen adequacy during an aspiration procedure.
In Puerto Rico, Medicare pays $54.44 for 88172 in the office.
Check a contract rate as a % of Medicare · 88172 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 88172 covers
This service is an immediate review of material collected by fine needle aspiration to determine whether the specimen is adequate for diagnostic work. It is commonly performed during aspiration of a thyroid nodule, lymph node, or other mass, with a cytopathologist or pathology team reviewing the material while the procedure is in progress. The adequacy assessment can help the proceduralist decide whether further passes or specimen triage are needed.
Report 88172 for the first site evaluated; additional sites are represented by 88177 rather than by counting repeat passes from the same site as new sites. Documentation should identify the aspirated site and record the on-site adequacy assessment. This service is distinct from the final diagnostic interpretation and report represented by 88173 when that work is also performed. CMS recognizes professional and technical components: modifier 26 reports interpretation, modifier TC reports equipment and staff, and billing without either modifier represents the global 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.
How Puerto Rico compares for 88172
Across 109 of 109 payment localities, the office rate for 88172 runs from $49.41 in Arkansas to $69.99 in San Benito County, CA. Puerto Rico pays $54.44. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$54.44
- Los Angeles, CA · California$60.49+$6.05
- Washington, DC area · District of Columbia$60.92+$6.48
- Miami, FL · Florida$56.40+$1.96
- Chicago, IL · Illinois$55.29+$0.85
- Manhattan, NY · New York$60.97+$6.53
- Alaska · Alaska$67.02+$12.58
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $49.94 | — |
| ArkansasArkansas | $49.41 | — |
| ArizonaArizona | $53.05 | — |
| Bakersfield, CACalifornia | $57.26 | — |
| Chico, CACalifornia | $57.16 | — |
| El Centro, CACalifornia | $57.17 | — |
| Fresno, CACalifornia | $57.16 | — |
| Hanford, CACalifornia | $57.16 | — |
| Madera, CACalifornia | $57.16 | — |
| Merced, CACalifornia | $57.16 | — |
| Modesto, CACalifornia | $57.16 | — |
| Napa, CACalifornia | $65.07 | — |
| Oxnard, CACalifornia | $60.14 | — |
| Redding, CACalifornia | $57.16 | — |
| Rest of CaliforniaCalifornia | $57.16 | — |
| Riverside, CACalifornia | $57.40 | — |
| Sacramento, CACalifornia | $59.67 | — |
| Salinas, CACalifornia | $59.43 | — |
| San Diego, CACalifornia | $60.56 | — |
| Marin County, CACalifornia | $68.61 | — |
| San Francisco, CACalifornia | $68.59 | — |
| San Benito County, CACalifornia | $69.99 | — |
| Santa Clara County, CACalifornia | $69.90 | — |
| San Luis Obispo, CACalifornia | $58.50 | — |
| Santa Cruz, CACalifornia | $60.95 | — |
| Santa Maria, CACalifornia | $59.58 | — |
| Santa Rosa, CACalifornia | $61.55 | — |
| Stockton, CACalifornia | $57.16 | — |
| Vallejo, CACalifornia | $65.04 | — |
| Visalia, CACalifornia | $57.16 | — |
| Yuba City, CACalifornia | $57.16 | — |
| ColoradoColorado | $56.22 | — |
| ConnecticutConnecticut | $57.09 | — |
| DelawareDelaware | $53.78 | — |
| Fort Lauderdale, FLFlorida | $55.05 | — |
| Rest of FloridaFlorida | $53.08 | — |
| Atlanta, GAGeorgia | $54.81 | — |
| Rest of GeorgiaGeorgia | $50.88 | — |
| Hawaii, Guam, HIHawaii | $58.08 | — |
| IowaIowa | $51.07 | — |
| IdahoIdaho | $51.27 | — |
| East St. Louis, ILIllinois | $52.30 | — |
| Rest of IllinoisIllinois | $51.78 | — |
| Suburban Chicago, ILIllinois | $55.62 | — |
| IndianaIndiana | $51.50 | — |
| KansasKansas | $50.80 | — |
| KentuckyKentucky | $50.60 | — |
| New Orleans, LALouisiana | $52.37 | — |
| Rest of LouisianaLouisiana | $50.51 | — |
| Metropolitan Boston, MAMassachusetts | $60.98 | — |
| Rest of MassachusettsMassachusetts | $55.98 | — |
| Baltimore area, MDMaryland | $56.89 | — |
| Rest of MarylandMaryland | $54.65 | — |
| Rest of MaineMaine | $51.37 | — |
| Southern Maine, MEMaine | $53.58 | — |
| Detroit, MIMichigan | $53.48 | — |
| Rest of MichiganMichigan | $51.49 | — |
| MinnesotaMinnesota | $54.54 | — |
| Metropolitan Kansas City, MOMissouri | $52.20 | — |
| Metropolitan St. Louis, MOMissouri | $52.62 | — |
| Rest of MissouriMissouri | $49.81 | — |
| MississippiMississippi | $49.62 | — |
| MontanaMontana | $54.11 | — |
| North CarolinaNorth Carolina | $51.79 | — |
| North DakotaNorth Dakota | $53.71 | — |
| NebraskaNebraska | $51.30 | — |
| New HampshireNew Hampshire | $55.30 | — |
| Northern New JerseyNew Jersey | $60.53 | — |
| Rest of New JerseyNew Jersey | $57.93 | — |
| New MexicoNew Mexico | $51.67 | — |
| NevadaNevada | $54.03 | — |
| NYC suburbs and Long Island, NYNew York | $61.99 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $58.21 | — |
| Queens, NYNew York | $61.49 | — |
| Rest of New YorkNew York | $52.36 | — |
| OhioOhio | $51.41 | — |
| OklahomaOklahoma | $50.64 | — |
| Portland, OROregon | $57.74 | — |
| Rest of OregonOregon | $53.79 | — |
| Metropolitan Philadelphia, PAPennsylvania | $55.91 | — |
| Rest of PennsylvaniaPennsylvania | $51.53 | — |
| Rhode IslandRhode Island | $55.49 | — |
| South CarolinaSouth Carolina | $51.65 | — |
| South DakotaSouth Dakota | $53.67 | — |
| TennesseeTennessee | $50.97 | — |
| Austin, TXTexas | $55.88 | — |
| Beaumont, TXTexas | $51.27 | — |
| Brazoria, TXTexas | $53.86 | — |
| Dallas, TXTexas | $54.09 | — |
| Fort Worth, TXTexas | $53.79 | — |
| Galveston, TXTexas | $53.96 | — |
| Houston, TXTexas | $54.32 | — |
| Rest of TexasTexas | $52.46 | — |
| UtahUtah | $52.18 | — |
| VirginiaVirginia | $53.38 | — |
| Virgin Islands, VIUnited States Virgin Islands | $54.44 | — |
| VermontVermont | $53.47 | — |
| Rest of WashingtonWashington | $55.89 | — |
| King County, WAWashington | $62.16 | — |
| WisconsinWisconsin | $52.34 | — |
| West VirginiaWest Virginia | $50.33 | — |
| WyomingWyoming | $53.94 | — |
88172 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.
$49.41
$67.02
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 | $67.02 | 1 |
| AL | $49.94 | 1 |
| AR | $49.41 | 1 |
| AZ | $53.05 | 1 |
| CA | $57.16–$69.99 | 29 |
| CO | $56.22 | 1 |
| CT | $57.09 | 1 |
| DC | $60.92 | 1 |
| DE | $53.78 | 1 |
| FL | $53.08–$56.40 | 3 |
| GA | $50.88–$54.81 | 2 |
| GU | $58.08 | 1 |
| HI | $58.08 | 1 |
| IA | $51.07 | 1 |
| ID | $51.27 | 1 |
| IL | $51.78–$55.62 | 4 |
| IN | $51.50 | 1 |
| KS | $50.80 | 1 |
| KY | $50.60 | 1 |
| LA | $50.51–$52.37 | 2 |
| MA | $55.98–$60.98 | 2 |
| MD | $54.65–$60.92 | 3 |
| ME | $51.37–$53.58 | 2 |
| MI | $51.49–$53.48 | 2 |
| MN | $54.54 | 1 |
| MO | $49.81–$52.62 | 3 |
| MS | $49.62 | 1 |
| MT | $54.11 | 1 |
| NC | $51.79 | 1 |
| ND | $53.71 | 1 |
| NE | $51.30 | 1 |
| NH | $55.30 | 1 |
| NJ | $57.93–$60.53 | 2 |
| NM | $51.67 | 1 |
| NV | $54.03 | 1 |
| NY | $52.36–$61.99 | 5 |
| OH | $51.41 | 1 |
| OK | $50.64 | 1 |
| OR | $53.79–$57.74 | 2 |
| PA | $51.53–$55.91 | 2 |
| PR | $54.44 | 1 |
| RI | $55.49 | 1 |
| SC | $51.65 | 1 |
| SD | $53.67 | 1 |
| TN | $50.97 | 1 |
| TX | $51.27–$55.88 | 8 |
| UT | $52.18 | 1 |
| VA | $53.38–$60.92 | 2 |
| VI | $54.44 | 1 |
| VT | $53.47 | 1 |
| WA | $55.89–$62.16 | 2 |
| WI | $52.34 | 1 |
| WV | $50.33 | 1 |
| WY | $53.94 | 1 |
How the 88172 rate is calculated
Each of 88172’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 · 88172
RVUs × geographic indexes × conversion factor
Work0.67
0.67 RVUs× 1.000 GPCI
Practice expense0.93
0.93 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.6200
Conversion factor
$33.4009
Medicare rate
$54.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,148
- Code
- 88172
- Physician work
- 0.67
- Practice expense
- 0.93
- Malpractice
- 0.02
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.67 | × 1.000 | 0.6700 |
| Practice expense | 0.93 | × 1.011 | 0.9402 |
| Malpractice | 0.02 | × 0.985 | 0.0197 |
| Total RVUs | 1.6299 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$54.44
Office: (0.67 × 1 + 0.93 × 1.011 + 0.02 × 0.985) × $33.4009 = $54.44
Payment rules and modifiers for 88172
The CMS indicators that decide how 88172 is paid alongside other services.
CMS payment indicators · 88172
FNA adequacy, first site
| 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
88172 without 26 · national office
$54.11
FNA adequacy, first site
88172-26 · Professional component
$33.07
Pays only the interpretation and report.
How 88172 has changed in Puerto Rico
88172 · Office / nonfacility
$54.44
Effective 2026-10-01
The base rate is $0.44 lower than on 2025-10-01, moving from $54.88 to $54.44 (0.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$54.88changed to$54.44
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.69 changed to 0.67
- Practice expense RVU 0.98 changed to 0.93
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$55.80changed to$54.88
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.96 changed to 0.98
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$54.89changed to$55.80
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$56.16changed to$54.89
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.94 changed to 0.96
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$55.91changed to$56.16
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$55.26changed to$55.91
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.88 changed to 0.94
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$56.07changed to$55.26
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.89 changed to 0.88
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$57.26changed to$56.07
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.87 changed to 0.89
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$57.87changed to$57.26
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.88 changed to 0.87
- Malpractice RVU 0.03 changed to 0.02
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$59.26changed to$57.87
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.92 changed to 0.88
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$53.10changed to$59.26
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.90 changed to 0.92
- Practice expense GPCI 0.856 changed to 1.007
- Malpractice GPCI 0.642 changed to 0.990
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$47.74changed to$53.10
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.705 changed to 0.856
- Malpractice GPCI 0.293 changed to 0.642
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$47.30changed to$47.74
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 0.88 changed to 0.90
- Malpractice RVU 0.02 changed to 0.03
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$47.06changed to$47.30
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$44.99changed to$47.06
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.81 changed to 0.88
- Practice expense GPCI 0.692 changed to 0.705
- Malpractice GPCI 0.271 changed to 0.293
Held through RVU15B.
January 1, 2014
RVU14A
$44.41changed to$44.99
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 0.90 changed to 0.81
- Practice expense GPCI 0.678 changed to 0.692
- Malpractice GPCI 0.249 changed to 0.271
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $44.41
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $54.44 | Not available in this setting | RVU26D |
| 2026-07-01 | $54.44 | Not available in this setting | RVU26C |
| 2026-04-01 | $54.44 | Not available in this setting | RVU26B |
| 2026-01-01 | $54.44 | Not available in this setting | RVU26A |
| 2025-10-01 | $54.88 | Not available in this setting | RVU25D |
| 2025-07-01 | $54.88 | Not available in this setting | RVU25C |
| 2025-04-01 | $54.88 | Not available in this setting | RVU25B |
| 2025-01-01 | $54.88 | Not available in this setting | RVU25A |
| 2024-10-01 | $55.80 | Not available in this setting | RVU24D |
| 2024-07-01 | $55.80 | Not available in this setting | RVU24C |
| 2024-04-01 | $55.80 | Not available in this setting | RVU24B |
| 2024-03-09 | $55.80 | Not available in this setting | RVU24AR |
| 2024-01-01 | $54.89 | Not available in this setting | RVU24A |
| 2023-10-01 | $56.16 | Not available in this setting | RVU23D |
| 2023-07-01 | $55.91 | Not available in this setting | RVU23C |
| 2023-04-01 | $55.91 | Not available in this setting | RVU23B |
| 2023-01-01 | $55.91 | Not available in this setting | RVU23A |
| 2022-10-01 | $55.26 | Not available in this setting | RVU22D |
| 2022-07-01 | $55.26 | Not available in this setting | RVU22C |
| 2022-04-01 | $55.26 | Not available in this setting | RVU22B |
| 2022-01-01 | $55.26 | Not available in this setting | RVU22A |
| 2021-10-01 | $56.07 | Not available in this setting | RVU21D |
| 2021-07-01 | $56.07 | Not available in this setting | RVU21C |
| 2021-04-01 | $56.07 | Not available in this setting | RVU21B |
| 2021-01-01 | $56.07 | Not available in this setting | RVU21A |
| 2020-10-01 | $57.26 | Not available in this setting | RVU20D |
| 2020-07-01 | $57.26 | Not available in this setting | RVU20C |
| 2020-04-01 | $57.26 | Not available in this setting | RVU20B |
| 2020-01-01 | $57.26 | Not available in this setting | RVU20A |
| 2019-10-01 | $57.87 | Not available in this setting | RVU19D |
| 2019-07-01 | $57.87 | Not available in this setting | RVU19C |
| 2019-04-01 | $57.87 | Not available in this setting | RVU19B |
| 2019-01-01 | $57.87 | Not available in this setting | RVU19A |
| 2018-10-01 | $59.26 | Not available in this setting | RVU18D |
| 2018-07-01 | $59.26 | Not available in this setting | RVU18C |
| 2018-04-01 | $59.26 | Not available in this setting | RVU18B |
| 2018-01-01 | $59.26 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $53.10 | Not available in this setting | RVU17D |
| 2017-07-01 | $53.10 | Not available in this setting | RVU17C |
| 2017-04-01 | $53.10 | Not available in this setting | RVU17B |
| 2017-01-01 | $53.10 | Not available in this setting | RVU17A |
| 2016-10-01 | $47.74 | Not available in this setting | RVU16D |
| 2016-07-01 | $47.74 | Not available in this setting | RVU16C |
| 2016-04-01 | $47.74 | Not available in this setting | RVU16B |
| 2016-01-01 | $47.74 | Not available in this setting | RVU16A |
| 2015-10-01 | $47.30 | Not available in this setting | RVU15D |
| 2015-07-01 | $47.30 | Not available in this setting | RVU15C |
| 2015-04-01 | $47.06 | Not available in this setting | RVU15B |
| 2015-01-01 | $47.06 | Not available in this setting | RVU15A |
| 2014-10-01 | $44.99 | Not available in this setting | RVU14D |
| 2014-07-01 | $44.99 | Not available in this setting | RVU14C |
| 2014-04-01 | $44.99 | Not available in this setting | RVU14B |
| 2014-01-01 | $44.99 | Not available in this setting | RVU14A |
| 2013-10-01 | $44.41 | Not available in this setting | RVU13D |
| 2013-07-01 | $44.41 | Not available in this setting | RVU13C |
| 2013-04-01 | $44.41 | Not available in this setting | RVU13B |
| 2013-01-01 | $44.41 | Not available in this setting | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
88172 billing questions
How is 88172 different from 88173?
88172 represents immediate review to assess specimen adequacy during the aspiration procedure. 88173 represents the diagnostic interpretation and report.
When is 88177 reported with 88172?
88172 covers the first site evaluated, and 88177 is the add-on for each additional site. Additional passes from the same site do not make it an additional site.
Can 88172 be reported with the FNA procedure?
Yes, when immediate cytopathology adequacy evaluation is performed in addition to the aspiration procedure. The aspiration code describes collecting the specimen; 88172 describes its on-site adequacy review.
Which modifiers identify the components?
Use modifier 26 for the professional interpretation or modifier TC for the technical work, including equipment and staff. Without either modifier, 88172 represents the global service.
What documentation supports 88172?
Document the site evaluated and the immediate adequacy assessment. The record should support that cytopathology review occurred during the aspiration, rather than only a later diagnostic 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
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