CPT code 88245: SCE analysis, baseline, 20–25 cells2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Baseline sister chromatid exchange analysis evaluates cultured cells for chromosome instability, typically during investigation of an inherited chromosome-breakage disorder.
Medicare pays $173.17 for 88245 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
$173.17
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
- Unchanged
- 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 88245 covers
This cytogenetic assay evaluates baseline sister chromatid exchange (SCE) in cultured cells during investigation of inherited chromosome-breakage or chromosome-instability disorders. A cytogenetics laboratory examines 20–25 cells and assesses exchanges between sister chromatids. The assay is commonly performed on cultured peripheral-blood lymphocytes; clinicians may order it when evaluating a suspected disorder such as Bloom syndrome.
Report 88245 for baseline SCE analysis of 20–25 cells, rather than conventional chromosome counting or stimulated SCE analysis. Medicare pays the test through the CLFS only. The 2026 national CLFS amount is $173.17, unchanged since 2020; one amount applies across all states and localities, without a geographic or office/facility adjustment. The test is excluded from the physician fee schedule.
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 88245
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 88245. 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 88245 with status X (excluded by statute), so the test itself is paid only from the CLFS.
88245 on the lab fee schedule since 2020
88245 · CLFS 2026 Q4 (current)
$173.17
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
88245 compared with similar tests
- 88264Chromosome analysis20-25 cells$144.61
- Choose 88245 for baseline sister chromatid exchange analysis. Choose 88264 for conventional chromosome analysis when the cell-count range is 20–25.
- 88248Breakage analysisBaseline, 50–100 cells$173.17
- 88245 represents baseline SCE analysis in 20–25 cells; 88248 represents stimulated SCE analysis in 50–100 cells.
- 88249Chromosome breakage test100 cells, clastogen stress$173.17
- 88245 is the baseline SCE code for 20–25 cells. Code 88249 is for stimulated SCE analysis in 100 cells.
88245 billing questions
How is 88245 different from 88264?
88245 is for baseline sister chromatid exchange analysis in 20–25 cells. Code 88264 is for conventional chromosome analysis with the same cell-count range.
Is 88245 reported per cell?
No. The 20–25 cells describe the scope of the baseline SCE analysis, not separate units for each cell.
What specimen is typically used?
The assay is generally performed on cultured peripheral-blood lymphocytes. Documentation should support the baseline SCE study and the 20–25-cell analysis.
How does Medicare pay for 88245?
Medicare pays 88245 through the CLFS only, at one national amount that applies across localities and settings. It is excluded from the physician fee schedule.
Should 88245 be used for stimulated SCE analysis?
No. Use 88245 for baseline SCE analysis; codes 88248 and 88249 represent stimulated SCE analyses with different cell-count ranges.
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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