CPT code 88248: Breakage analysis, baseline, 50–100 cells2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Baseline chromosome breakage analysis evaluates chromosomal instability in suspected breakage syndromes, scoring 50–100 cells and counting 20 cells for the study.
Medicare pays $173.17 for 88248 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 88248 covers
This cytogenetic study evaluates baseline chromosome breakage when a chromosome-instability disorder is suspected, including conditions such as Fanconi anemia, ataxia-telangiectasia, or fragile X syndrome. A cytogenetics laboratory scores 50–100 cells and counts 20 cells, with two karyotypes included in the study. The code identifies baseline breakage analysis, rather than a routine chromosome analysis or an induced-breakage study.
Report the service for the baseline breakage study as a whole; the cell scoring and counting are part of the code’s defined scope. Medicare pays it under the CLFS, not the physician fee schedule. The 2026 national CLFS amount is $173.17, unchanged from 2020 through 2026. The same amount applies in every state and locality, with no geographic or office-versus-facility adjustment.
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 88248
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 88248. 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 88248 with status X (excluded by statute), so the test itself is paid only from the CLFS.
88248 on the lab fee schedule since 2020
88248 · 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.
88248 compared with similar tests
- 88245SCE analysisBaseline, 20–25 cells$173.17
- Both are baseline breakage studies; 88245 uses a lower cell-scoring range, while this code covers scoring 50–100 cells.
- 88249Chromosome breakage test100 cells, clastogen stress$173.17
- 88249 is for induced chromosome breakage. Use this code for baseline breakage analysis.
- 88264Chromosome analysis20-25 cells$144.61
- 88264 is a routine chromosome analysis with a 20–25-cell count. This code is for baseline breakage analysis and includes its specified scoring and karyotyping scope.
88248 billing questions
How does this differ from code 88249?
This code is for baseline chromosome breakage analysis. Code 88249 describes induced breakage analysis.
How does this differ from code 88245?
Both address baseline breakage analysis, but 88245 is the lower cell-scoring range. This code covers scoring 50–100 cells.
Are the cell count and karyotypes separately reported?
The code’s scope includes scoring 50–100 cells, counting 20 cells, and two karyotypes. These elements are not separate tests within this code.
Does Medicare pay this through the physician fee schedule?
No. Medicare pays this test only through the CLFS, using one national amount across localities and settings.
What should the laboratory documentation support?
Document that the study evaluates baseline chromosome breakage, along with the cell scoring and counting performed for the analysis.
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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