CPT code 88264: Chromosome analysis, 20-25 cells2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Cytogenetic chromosome analysis evaluates 20-25 cells for chromosome abnormalities during the diagnostic workup of suspected genetic defects.
Medicare pays $144.61 for 88264 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
$144.61
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 88264 covers
A cytogenetics laboratory examines 20-25 cells for chromosome abnormalities relevant to genetic diagnosis. Chromosome analysis evaluates chromosome number and structure, and may be ordered when a clinician is investigating a suspected genetic or chromosomal condition. The analyzed cell count distinguishes this service from chromosome-analysis codes for other counts.
Report 88264 for the 20-25-cell analysis; the cell count is part of the service definition, not the number of claim units. Medicare pays this test through the CLFS only. The 2026 national CLFS amount is $144.61, unchanged from 2020 through 2026. The same amount applies in every state and locality, without an office or facility difference. The code 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 88264
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 88264. 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 88264 with status X (excluded by statute), so the test itself is paid only from the CLFS.
88264 on the lab fee schedule since 2020
88264 · CLFS 2026 Q4 (current)
$144.61
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.
88264 compared with similar tests
- 88262Chromosome analysis15–20 cells, two karyotypes$125.49
- Use 88262 when the analysis matches its cell-count range. Choose 88264 when 20-25 cells are analyzed.
- 88263Chromosome analysis45 cells for mosaicism$150.29
- 88263 represents analysis of 45 cells. It is not the 20-25-cell service represented by 88264.
- 88269Amniotic karyotypeSix to 12 colonies$173.66
- 88269 is designated for chromosome analysis of amniotic fluid. 88264 is distinguished by its 20-25-cell count.
- 88271DNA probeEach probe$21.42
- 88271 represents DNA-probe cytogenetic testing; 88264 represents chromosome analysis based on examining 20-25 cells.
88264 billing questions
How does 88264 differ from 88262?
88264 is for analysis of 20-25 cells; 88262 is for a different cell-count range. Select the code that matches the analysis performed.
When should 88269 be considered instead?
88269 is a specimen-specific chromosome-analysis code for amniotic fluid testing. Use it when that defined specimen-based service applies rather than choosing by cell count alone.
Does the 20-25-cell count mean 20-25 claim units?
No. The count identifies the analysis represented by 88264; it is not the number of units to report.
How does Medicare pay for 88264?
Medicare pays 88264 through the CLFS. Payment is nationally priced and the same across localities and office or facility settings.
What should the laboratory record support?
The laboratory record should support the chromosome analysis performed and the applicable 20-25-cell count.
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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