Billing code 88177: FNA adequacyMedicare rate & RVUs
Reports an additional immediate adequacy evaluation of fine-needle aspirate material from the same site during a diagnostic sampling encounter.
Medicare pays $29.06 for 88177 nationally in the office. Local office rates run $26.78–$37.05.
Medicare rate · 88177
FNA adequacy
- Work RVUs
- 0.41
- Total RVUs
- 0.87
- Global days
- ZZZ
National rate · 2026
$29.06
Office setting, before claim adjustments.
See every locality for 88177 →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 88177 covers
A cytopathology team uses this service when additional material from a fine-needle aspiration (FNA) needs another immediate adequacy check at the same site. For example, during thyroid nodule or lymph node sampling, a pathologist or cytotechnologist may assess prepared material while the clinician is still collecting specimens. The evaluation helps determine whether the sample is sufficient for diagnostic work; it is not the final interpretation and report of the aspirate.
Report 88177 only as an add-on with the first evaluation code, 88172, for an additional evaluation episode at that same site. Documentation should identify the site, distinguish the additional episode from the first, and record the adequacy finding. The code is paid within the primary procedure’s global period. It has professional and technical components: modifier 26 identifies interpretation, modifier TC identifies the technical service, and no modifier represents the global service.
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 88177 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
$26.78 to $37.05
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $27.04 | Unavailable |
| Alaska* | $36.73 | Unavailable |
| Arizona | $28.54 | Unavailable |
| Arkansas | $26.78 | Unavailable |
| Atlanta | $29.41 | Unavailable |
| Austin | $29.92 | Unavailable |
| Bakersfield | $30.63 | Unavailable |
| Baltimore/Surr. Cntys | $30.45 | Unavailable |
| Beaumont | $27.68 | Unavailable |
| Brazoria | $28.96 | Unavailable |
| Chicago | $29.66 | Unavailable |
| Chico | $30.58 | Unavailable |
| Colorado | $30.11 | Unavailable |
| Connecticut | $30.56 | Unavailable |
| Dallas | $29.07 | Unavailable |
| Dc + Md/Va Suburbs | $32.51 | Unavailable |
| Delaware | $28.91 | Unavailable |
| Detroit | $28.76 | Unavailable |
| East St. Louis | $28.20 | Unavailable |
| El Centro | $30.58 | Unavailable |
| Fort Lauderdale | $29.52 | Unavailable |
| Fort Worth | $28.93 | Unavailable |
| Fresno | $30.58 | Unavailable |
| Galveston | $29.01 | Unavailable |
| Hanford-Corcoran | $30.58 | Unavailable |
| Hawaii, Guam | $30.98 | Unavailable |
| Houston | $29.19 | Unavailable |
| Idaho | $27.68 | Unavailable |
| Indiana | $27.79 | Unavailable |
| Iowa | $27.58 | Unavailable |
| Kansas | $27.45 | Unavailable |
| Kentucky | $27.36 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $32.26 | Unavailable |
| Madera | $30.58 | Unavailable |
| Manhattan | $32.57 | Unavailable |
| Merced | $30.58 | Unavailable |
| Metropolitan Boston | $32.50 | Unavailable |
| Metropolitan Kansas City | $28.13 | Unavailable |
| Metropolitan Philadelphia | $29.99 | Unavailable |
| Metropolitan St. Louis | $28.34 | Unavailable |
| Miami | $30.19 | Unavailable |
| Minnesota | $29.26 | Unavailable |
| Mississippi | $26.88 | Unavailable |
| Modesto | $30.58 | Unavailable |
| Montana** | $29.06 | Unavailable |
| Napa | $34.54 | Unavailable |
| Nebraska | $27.69 | Unavailable |
| Nevada** | $29.02 | Unavailable |
| New Hampshire | $29.63 | Unavailable |
| New Mexico | $27.88 | Unavailable |
| New Orleans | $28.22 | Unavailable |
| North Carolina | $27.93 | Unavailable |
| North Dakota** | $28.86 | Unavailable |
| Northern Nj | $32.35 | Unavailable |
| Nyc Suburbs/Long Island | $33.06 | Unavailable |
| Ohio | $27.75 | Unavailable |
| Oklahoma | $27.38 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $32.05 | Unavailable |
| Portland | $30.86 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $31.17 | Unavailable |
| Puerto Rico | $29.22 | Unavailable |
| Queens | $32.82 | Unavailable |
| Redding | $30.58 | Unavailable |
| Rest Of California | $30.58 | Unavailable |
| Rest Of Florida | $28.57 | Unavailable |
| Rest Of Georgia | $27.50 | Unavailable |
| Rest Of Illinois | $27.94 | Unavailable |
| Rest Of Louisiana | $27.32 | Unavailable |
| Rest Of Maine | $27.73 | Unavailable |
| Rest Of Maryland | $29.35 | Unavailable |
| Rest Of Massachusetts | $30.01 | Unavailable |
| Rest Of Michigan | $27.79 | Unavailable |
| Rest Of Missouri | $26.98 | Unavailable |
| Rest Of New Jersey | $31.02 | Unavailable |
| Rest Of New York | $28.21 | Unavailable |
| Rest Of Oregon | $28.90 | Unavailable |
| Rest Of Pennsylvania | $27.81 | Unavailable |
| Rest Of Texas | $28.26 | Unavailable |
| Rest Of Washington | $29.95 | Unavailable |
| Rhode Island | $29.78 | Unavailable |
| Riverside-San Bernardino-Ontario | $30.70 | Unavailable |
| Sacramento-Roseville-Folsom | $31.85 | Unavailable |
| Salinas | $31.72 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $32.26 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $36.34 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $36.33 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $37.05 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $37.01 | Unavailable |
| San Luis Obispo-Paso Robles | $31.23 | Unavailable |
| Santa Cruz-Watsonville | $32.42 | Unavailable |
| Santa Maria-Santa Barbara | $31.78 | Unavailable |
| Santa Rosa-Petaluma | $32.74 | Unavailable |
| Seattle (King Cnty) | $33.09 | Unavailable |
| South Carolina | $27.87 | Unavailable |
| South Dakota** | $28.84 | Unavailable |
| Southern Maine | $28.80 | Unavailable |
| Stockton | $30.58 | Unavailable |
| Suburban Chicago | $29.82 | Unavailable |
| Tennessee | $27.54 | Unavailable |
| Utah | $28.12 | Unavailable |
| Vallejo | $34.52 | Unavailable |
| Vermont | $28.74 | Unavailable |
| Virgin Islands | $29.22 | Unavailable |
| Virginia | $28.71 | Unavailable |
| Visalia | $30.58 | Unavailable |
| West Virginia | $27.23 | Unavailable |
| Wisconsin | $28.20 | Unavailable |
| Wyoming** | $28.97 | Unavailable |
| Yuba City | $30.58 | Unavailable |
88177 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.
$26.78
$36.73
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 | $36.73 | 1 |
| AL | $27.04 | 1 |
| AR | $26.78 | 1 |
| AZ | $28.54 | 1 |
| CA | $30.58–$37.05 | 29 |
| CO | $30.11 | 1 |
| CT | $30.56 | 1 |
| DC | $32.51 | 1 |
| DE | $28.91 | 1 |
| FL | $28.57–$30.19 | 3 |
| GA | $27.50–$29.41 | 2 |
| GU | $30.98 | 1 |
| HI | $30.98 | 1 |
| IA | $27.58 | 1 |
| ID | $27.68 | 1 |
| IL | $27.94–$29.82 | 4 |
| IN | $27.79 | 1 |
| KS | $27.45 | 1 |
| KY | $27.36 | 1 |
| LA | $27.32–$28.22 | 2 |
| MA | $30.01–$32.50 | 2 |
| MD | $29.35–$32.51 | 3 |
| ME | $27.73–$28.80 | 2 |
| MI | $27.79–$28.76 | 2 |
| MN | $29.26 | 1 |
| MO | $26.98–$28.34 | 3 |
| MS | $26.88 | 1 |
| MT | $29.06 | 1 |
| NC | $27.93 | 1 |
| ND | $28.86 | 1 |
| NE | $27.69 | 1 |
| NH | $29.63 | 1 |
| NJ | $31.02–$32.35 | 2 |
| NM | $27.88 | 1 |
| NV | $29.02 | 1 |
| NY | $28.21–$33.06 | 5 |
| OH | $27.75 | 1 |
| OK | $27.38 | 1 |
| OR | $28.90–$30.86 | 2 |
| PA | $27.81–$29.99 | 2 |
| PR | $29.22 | 1 |
| RI | $29.78 | 1 |
| SC | $27.87 | 1 |
| SD | $28.84 | 1 |
| TN | $27.54 | 1 |
| TX | $27.68–$29.92 | 8 |
| UT | $28.12 | 1 |
| VA | $28.71–$32.51 | 2 |
| VI | $29.22 | 1 |
| VT | $28.74 | 1 |
| WA | $29.95–$33.09 | 2 |
| WI | $28.20 | 1 |
| WV | $27.23 | 1 |
| WY | $28.97 | 1 |
How the 88177 rate is calculated
Each of 88177’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 · 88177
RVUs × geographic indexes × conversion factor
Work0.41
0.41 RVUs× 1.000 GPCI
Practice expense0.45
0.45 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.8700
Conversion factor
$33.4009
Medicare rate
$29.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 88177
The CMS indicators that decide how 88177 is paid alongside other services.
CMS payment indicators · 88177
FNA adequacy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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
88177 without 26 · national office
$29.06
FNA adequacy
88177-26 · Professional component
$20.37
Pays only the interpretation and report.
88177 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 88172FNA adequacy
- 88172 represents the first immediate adequacy evaluation at a site; 88177 represents each additional evaluation episode at that same site.
- 88173FNA cytology
- 88173 is the diagnostic interpretation and report of the FNA material, rather than an additional immediate adequacy check during sampling.
- 10021Fine needle aspiration
- 10021 describes FNA sampling without imaging guidance. 88177 describes an additional cytopathology adequacy evaluation of material obtained from the sampling.
88177 billing questions
When should 88177 be reported instead of 88172?
Use 88172 for the first immediate adequacy evaluation at a site. Report 88177 for each additional evaluation episode at that same site.
Does each needle pass count as a unit?
The code represents an additional evaluation episode, not automatically each needle pass. Document the additional adequacy evaluation rather than relying on the number of passes alone.
Can 88177 be reported without 88172?
No. It is an add-on code and must be reported with the primary evaluation code, 88172.
How does 88177 differ from 88173?
88177 covers an additional immediate check of specimen adequacy during FNA sampling. 88173 represents the diagnostic interpretation and report.
Which modifier identifies the pathologist's interpretation?
Modifier 26 identifies the professional component. Modifier TC identifies the technical component; reporting without either modifier represents the global service.
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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