Billing code 88120: Urine FISHMedicare rate & RVUs
Reports FISH analysis of a urinary tract specimen using three to five molecular probes, commonly to assess for urothelial carcinoma-associated chromosomal changes.
Medicare pays $542.10 for 88120 nationally in the office. Local office rates run $470.60–$767.22.
Medicare rate · 88120
Urine FISH
Swap in your local Medicare rate.
- Work RVUs
- 1.17
- Total RVUs
- 16.23
- Global days
- XXX
National rate · 2026
$542.10
Office setting, before claim adjustments.
See every locality for 88120 → · Billed by an NP, PA or therapist? →
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 10 sections
What 88120 covers
This service uses fluorescent in situ hybridization to assess cells in a urinary tract specimen for chromosomal changes associated with urothelial carcinoma. It is commonly used in the evaluation or surveillance of patients with a history of bladder cancer, including when urine testing is used to look for evidence of recurrent disease. Laboratory personnel prepare and process the specimen; a pathologist interprets the findings. The code represents analysis with three to five probes for each specimen, rather than conventional microscopic urine cytology.
Report one unit for each specimen analyzed under the three-to-five-probe method. Documentation should identify the specimen, the FISH analysis performed, the probes or probe set used, and the interpreted result. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff work. Report without either modifier when billing the global service, which includes both components.
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.
Where 88120 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$470.60 to $767.22
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $478.70 | Unavailable |
| Alaska* | $593.47 | Unavailable |
| Arizona | $526.31 | Unavailable |
| Arkansas | $470.60 | Unavailable |
| Atlanta | $550.57 | Unavailable |
| Austin | $571.06 | Unavailable |
| Bakersfield | $590.32 | Unavailable |
| Baltimore/Surr. Cntys | $579.72 | Unavailable |
| Beaumont | $496.86 | Unavailable |
| Brazoria | $537.53 | Unavailable |
| Chicago | $547.04 | Unavailable |
| Chico | $590.12 | Unavailable |
| Colorado | $574.29 | Unavailable |
| Connecticut | $581.83 | Unavailable |
| Dallas | $540.21 | Unavailable |
| Dc + Md/Va Suburbs | $633.64 | Unavailable |
| Delaware | $536.11 | Unavailable |
| Detroit | $525.70 | Unavailable |
| East St. Louis | $503.68 | Unavailable |
| El Centro | $590.12 | Unavailable |
| Fort Lauderdale | $549.96 | Unavailable |
| Fort Worth | $535.21 | Unavailable |
| Fresno | $590.12 | Unavailable |
| Galveston | $538.61 | Unavailable |
| Hanford-Corcoran | $590.12 | Unavailable |
| Hawaii, Guam | $610.08 | Unavailable |
| Houston | $539.53 | Unavailable |
| Idaho | $501.11 | Unavailable |
| Indiana | $504.64 | Unavailable |
| Iowa | $498.48 | Unavailable |
| Kansas | $493.14 | Unavailable |
| Kentucky | $486.31 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $634.88 | Unavailable |
| Madera | $590.12 | Unavailable |
| Manhattan | $626.79 | Unavailable |
| Merced | $590.12 | Unavailable |
| Metropolitan Boston | $640.78 | Unavailable |
| Metropolitan Kansas City | $511.48 | Unavailable |
| Metropolitan Philadelphia | $563.68 | Unavailable |
| Metropolitan St. Louis | $518.04 | Unavailable |
| Miami | $565.21 | Unavailable |
| Minnesota | $555.46 | Unavailable |
| Mississippi | $471.97 | Unavailable |
| Modesto | $590.12 | Unavailable |
| Montana** | $542.09 | Unavailable |
| Napa | $703.17 | Unavailable |
| Nebraska | $502.45 | Unavailable |
| Nevada** | $542.32 | Unavailable |
| New Hampshire | $562.44 | Unavailable |
| New Mexico | $500.82 | Unavailable |
| New Orleans | $512.74 | Unavailable |
| North Carolina | $507.90 | Unavailable |
| North Dakota** | $541.10 | Unavailable |
| Northern Nj | $624.89 | Unavailable |
| Nyc Suburbs/Long Island | $640.78 | Unavailable |
| Ohio | $498.49 | Unavailable |
| Oklahoma | $488.08 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $633.81 | Unavailable |
| Portland | $597.94 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $591.83 | Unavailable |
| Puerto Rico | $547.59 | Unavailable |
| Queens | $636.58 | Unavailable |
| Redding | $590.12 | Unavailable |
| Rest Of California | $590.12 | Unavailable |
| Rest Of Florida | $520.88 | Unavailable |
| Rest Of Georgia | $488.27 | Unavailable |
| Rest Of Illinois | $499.42 | Unavailable |
| Rest Of Louisiana | $484.37 | Unavailable |
| Rest Of Maine | $501.36 | Unavailable |
| Rest Of Maryland | $548.37 | Unavailable |
| Rest Of Massachusetts | $568.95 | Unavailable |
| Rest Of Michigan | $498.69 | Unavailable |
| Rest Of Missouri | $472.87 | Unavailable |
| Rest Of New Jersey | $589.95 | Unavailable |
| Rest Of New York | $516.53 | Unavailable |
| Rest Of Oregon | $539.60 | Unavailable |
| Rest Of Pennsylvania | $500.89 | Unavailable |
| Rest Of Texas | $516.37 | Unavailable |
| Rest Of Washington | $568.78 | Unavailable |
| Rhode Island | $559.20 | Unavailable |
| Riverside-San Bernardino-Ontario | $590.68 | Unavailable |
| Sacramento-Roseville-Folsom | $624.45 | Unavailable |
| Salinas | $622.25 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $640.77 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $750.46 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $750.40 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $767.22 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $766.98 | Unavailable |
| San Luis Obispo-Paso Robles | $611.67 | Unavailable |
| Santa Cruz-Watsonville | $649.93 | Unavailable |
| Santa Maria-Santa Barbara | $625.64 | Unavailable |
| Santa Rosa-Petaluma | $656.80 | Unavailable |
| Seattle (King Cnty) | $657.55 | Unavailable |
| South Carolina | $503.74 | Unavailable |
| South Dakota** | $540.99 | Unavailable |
| Southern Maine | $536.97 | Unavailable |
| Stockton | $590.12 | Unavailable |
| Suburban Chicago | $557.20 | Unavailable |
| Tennessee | $495.70 | Unavailable |
| Utah | $511.85 | Unavailable |
| Vallejo | $703.08 | Unavailable |
| Vermont | $536.26 | Unavailable |
| Virgin Islands | $547.59 | Unavailable |
| Virginia | $533.08 | Unavailable |
| Visalia | $590.12 | Unavailable |
| West Virginia | $477.14 | Unavailable |
| Wisconsin | $519.88 | Unavailable |
| Wyoming** | $541.66 | Unavailable |
| Yuba City | $590.12 | Unavailable |
88120 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.
$470.60
$678.67
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 | $593.47 | 1 |
| AL | $478.70 | 1 |
| AR | $470.60 | 1 |
| AZ | $526.31 | 1 |
| CA | $590.12–$767.22 | 29 |
| CO | $574.29 | 1 |
| CT | $581.83 | 1 |
| DC | $633.64 | 1 |
| DE | $536.11 | 1 |
| FL | $520.88–$565.21 | 3 |
| GA | $488.27–$550.57 | 2 |
| GU | $610.08 | 1 |
| HI | $610.08 | 1 |
| IA | $498.48 | 1 |
| ID | $501.11 | 1 |
| IL | $499.42–$557.20 | 4 |
| IN | $504.64 | 1 |
| KS | $493.14 | 1 |
| KY | $486.31 | 1 |
| LA | $484.37–$512.74 | 2 |
| MA | $568.95–$640.78 | 2 |
| MD | $548.37–$633.64 | 3 |
| ME | $501.36–$536.97 | 2 |
| MI | $498.69–$525.70 | 2 |
| MN | $555.46 | 1 |
| MO | $472.87–$518.04 | 3 |
| MS | $471.97 | 1 |
| MT | $542.09 | 1 |
| NC | $507.90 | 1 |
| ND | $541.10 | 1 |
| NE | $502.45 | 1 |
| NH | $562.44 | 1 |
| NJ | $589.95–$624.89 | 2 |
| NM | $500.82 | 1 |
| NV | $542.32 | 1 |
| NY | $516.53–$640.78 | 5 |
| OH | $498.49 | 1 |
| OK | $488.08 | 1 |
| OR | $539.60–$597.94 | 2 |
| PA | $500.89–$563.68 | 2 |
| PR | $547.59 | 1 |
| RI | $559.20 | 1 |
| SC | $503.74 | 1 |
| SD | $540.99 | 1 |
| TN | $495.70 | 1 |
| TX | $496.86–$571.06 | 8 |
| UT | $511.85 | 1 |
| VA | $533.08–$633.64 | 2 |
| VI | $547.59 | 1 |
| VT | $536.26 | 1 |
| WA | $568.78–$657.55 | 2 |
| WI | $519.88 | 1 |
| WV | $477.14 | 1 |
| WY | $541.66 | 1 |
How the 88120 rate is calculated
Each of 88120’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 · 88120
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.17Practice expense 15.01Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 88120
The CMS indicators that decide how 88120 is paid alongside other services.
CMS payment indicators · 88120
Urine FISH
| 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
88120 without 26 · national office
$542.10
Urine FISH
88120-26 · Professional component
$54.44
Pays only the interpretation and report.
88120 compared with similar codes
Compare codes
88120 vs 88121 vs 88112 vs 88108: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 88121Urine FISH
- Both apply to urinary tract specimen FISH with three to five probes. The distinction is computer-assisted analysis under 88121 versus the method represented by 88120.
- 88112Selective-enhancement cytology
- 88112 reports cell-enhanced cytopathology preparation and examination. 88120 reports FISH probe analysis for chromosomal changes, not cell morphology alone.
- 88108Concentrated cytology
- 88108 is for cytopathology of a concentrated fluid specimen. 88120 is selected for urinary tract specimen FISH using three to five molecular probes.
88120 billing questions
How does 88120 differ from 88121?
Both describe urinary tract specimen FISH using three to five probes. 88121 is the related code for analysis using computer-assisted technology; select the code that matches the method documented.
Is this conventional urine cytology?
No. This code is for fluorescent in situ hybridization to detect chromosomal changes. Conventional cytology evaluates cell appearance and is reported with a different cytopathology code.
How many units are reported?
Report per specimen analyzed with the three-to-five-probe method. The probe count does not create a separate unit for each probe.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation alone and modifier TC for the technical work alone. An unmodified claim represents the global service, including both components.
What documentation supports the service?
Record the urinary tract specimen, the FISH method and probe set, the analysis performed, and the interpreted findings. The documentation should support that three to five probes were used for each specimen.
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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