CPT code 88272: Cytogenetics, three to five cells2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Chromosomal in situ hybridization assesses chromosome abnormalities in three to five cells, including targeted evaluation of derivatives or marker chromosomes.
Medicare pays $40.70 for 88272 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
$40.70
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 88272 covers
This laboratory cytogenetic analysis uses in situ hybridization to assess chromosome-related genetic defects in three to five analyzed cells. It is used for targeted evaluation of chromosome findings such as derivatives or marker chromosomes. The reported cell count distinguishes this service from related cytogenetic analysis codes with higher cell-count ranges. The service is distinguished by both the in situ hybridization method and the small analyzed-cell range.
Report 88272 for analysis of three to five cells. Medicare pays the test through the CLFS at one national amount per code, applicable across all states and localities without geographic or office or facility adjustment. The 2026 national CLFS amount is $40.70, unchanged from 2020 through 2026. The code is excluded from the physician fee schedule by statute, so Medicare payment for the test is through the CLFS.
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 88272
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 88272. 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 88272 with status X (excluded by statute), so the test itself is paid only from the CLFS.
88272 on the lab fee schedule since 2020
88272 · CLFS 2026 Q4 (current)
$40.70
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.
88272 compared with similar tests
- 88273Chromosome probe test10–30 cells analyzed$34.81
- 88273 is for cytogenetics analysis in the 10-to-30-cell range; 88272 is for in situ hybridization analysis of three to five cells.
- 88274Interphase FISH25–99 cells analyzed$42.38
- 88274 is listed for analysis of 25 to 99 cells, rather than the three-to-five-cell range for 88272.
- 88275Interphase ISH100–300 cells$51.19
- 88275 is listed for analysis of 100 to 300 cells; 88272 is for in situ hybridization analysis of three to five cells.
- 88261Chromosome analysisFive-cell count$264.34
- 88261 is chromosome analysis for five cells. Code 88272 describes in situ hybridization cytogenetic analysis for three to five cells.
88272 billing questions
When should 88272 be selected instead of 88273?
Use 88272 for in situ hybridization analysis of three to five cells. Code 88273 is for cytogenetics analysis in the 10-to-30-cell range.
How does 88272 differ from 88274?
88272 covers analysis of three to five cells; 88274 is listed for the 25-to-99-cell range.
What should documentation support for 88272?
Documentation should support that the service was chromosomal in situ hybridization and that three to five cells were analyzed.
How does 88272 differ from 88261?
88261 is chromosome analysis for five cells. Code 88272 describes in situ hybridization cytogenetic analysis for three to five cells.
How does Medicare pay for 88272?
Medicare pays it through the CLFS at one national amount per code across localities, with no geographic or office or 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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