CPT code 88360: Tumor IHC scoring2026 Medicare rate & RVUs

Manual quantitative or semiquantitative scoring of a tumor immunohistochemical stain, such as ER, PR, HER2, or Ki-67, reported per specimen and single-antibody stain procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities729.1K Medicare services in 2024

Medicare pays $120.24 for 88360 nationally in the office. Local office rates run $106.97–$163.58.

Medicare rate · 88360

Tumor IHC scoring

Work RVUs
0.83
Total RVUs
3.60
Global days
XXX

National rate · 2026

$120.24

Office setting, before claim adjustments.

See every locality for 88360 →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
  1. Medicare rate
  2. What 88360 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 88360 covers

This service includes immunohistochemical staining of tumor tissue and a pathologist's manual quantitative or semiquantitative assessment, rather than a qualitative interpretation alone. Common uses in breast carcinoma include estrogen and progesterone receptor scoring, HER2 membrane scoring on a 0 to 3+ scale, and the Ki-67 proliferation index. Hospital and independent pathology laboratories perform the staining; a pathologist assesses the stained cells at the microscope on a biopsy or resection specimen.

Report one unit for each single-antibody stain procedure scored manually on each separately evaluated specimen. If computer-assisted image analysis performs the quantitation, report 88361 instead. Do not add a qualitative IHC code for the same antibody stain procedure; qualitative stains using other antibodies may be reported separately when supported. Documentation should identify the specimen, antibody, manual scoring method, and result. CMS prices professional and technical components separately: modifier 26 identifies the pathologist's interpretation, modifier TC identifies the staining and other technical work, and the unmodified code represents both components when furnished by one billing entity.

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 88360 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

$106.97 to $163.58

$106.97$135.28$163.58
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

88360 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$108.47Unavailable
Alaska*$139.78Unavailable
Arizona$117.30Unavailable
Arkansas$106.97Unavailable
Atlanta$121.93Unavailable
Austin$125.55Unavailable
Bakersfield$129.33Unavailable
Baltimore/Surr. Cntys$127.55Unavailable
Beaumont$111.93Unavailable
Brazoria$119.49Unavailable

88360 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.

$106.97

$146.40

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
88360 office rate range by state
State / territoryOffice rate rangeLocalities
AK$139.781
AL$108.471
AR$106.971
AZ$117.301
CA$129.22–$163.5829
CO$126.311
CT$128.011
DC$138.171
DE$119.211
FL$116.54–$125.033
GA$110.45–$121.932
GU$132.551
HI$132.551
IA$112.031
ID$112.541
IL$112.63–$123.434
IN$113.191
KS$111.091
KY$109.991
LA$109.65–$114.912
MA$125.42–$139.132
MD$121.57–$138.173
ME$112.64–$119.172
MI$112.34–$117.492
MN$122.441
MO$107.55–$115.843
MS$107.301
MT$120.241
NC$113.851
ND$119.851
NE$112.761
NH$123.931
NJ$129.87–$136.732
NM$112.751
NV$120.221
NY$115.45–$139.955
OH$112.261
OK$110.271
OR$119.68–$130.712
PA$112.67–$124.642
PR$121.241
RI$123.731
SC$113.161
SD$119.801
TN$111.581
TX$111.93–$125.558
UT$114.661
VA$118.49–$138.172
VI$121.241
VT$118.991
WA$125.31–$142.362
WI$115.921
WV$108.501
WY$120.071

How the 88360 rate is calculated

Each of 88360’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 · 88360

RVUs × geographic indexes × conversion factor

Work0.83

0.83 RVUs× 1.000 GPCI

Practice expense2.75

2.75 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

3.6000

Conversion factor

$33.4009

Medicare rate

$120.24

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 88360

The CMS indicators that decide how 88360 is paid alongside other services.

CMS payment indicators · 88360

Tumor IHC scoring

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

88360 without 26 · national office

$120.24

Tumor IHC scoring

88360-26 · Professional component

$39.08

Pays only the interpretation and report.

When to use modifier 26

88360 compared with similar codes

Compare codes · National

4 codes, side by side

  • 88360

    Tumor IHC scoring0.83 wRVU

    $120.24

  • 88361

    Tumor immunohistochemistry0.93 wRVU

    $114.57−$5.67

  • 88342

    Antibody stain0.68 wRVU

    $110.22−$10.02

  • 88341

    Immunostain0.55 wRVU

    $94.19−$26.05

How to choose

88361Tumor immunohistochemistry
88360 covers manual quantitative or semiquantitative tumor IHC assessment; 88361 covers computer-assisted image analysis. Choose according to the method documented for the stain procedure.
88342Antibody stain
88342 is the initial single-antibody IHC stain procedure on a specimen when assessed qualitatively. Choose 88360 when a tumor antibody stain procedure receives documented manual quantitative or semiquantitative assessment.
88341Immunostain
88341 covers an additional single-antibody IHC stain procedure assessed qualitatively and is reported with the initial procedure code. It is not added to 88360 for the same antibody stain procedure.

88360 billing questions

When is 88360 reported instead of 88342?

Use 88360 for documented manual quantitative or semiquantitative tumor IHC assessment, such as an ER percentage or HER2 0 to 3+ score. Use 88342 for the first single-antibody IHC stain procedure on a specimen when the work is a qualitative assessment.

How many units are reported for an ER, PR, and HER2 panel on one breast biopsy?

Report three units if each single-antibody stain procedure is manually scored on that specimen. Count a second separately evaluated specimen separately when those stains are also performed and scored on it.

Can 88342 or 88341 be billed with 88360 for the same antibody?

Do not add a qualitative IHC code for the same antibody stain procedure on the same specimen. Qualitative stains for different antibodies may be reported separately when supported.

What if image analysis software is used to score the stain?

Report 88361 instead of 88360 when computer-assisted image analysis performs the quantitative or semiquantitative assessment. Do not report both for the same stain procedure on the same specimen.

Which modifier does a hospital-based pathologist use?

When the hospital performs the technical work and the pathologist bills only for interpretation, the pathologist reports 88360 with modifier 26. Modifier TC identifies a separately billed technical component; an entity furnishing and billing both components reports the global service without either modifier.

What documentation supports 88360?

The report should identify the specimen and antibody, document manual quantitative or semiquantitative assessment, and give the score or measured result, such as the percentage of positive tumor nuclei.

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
RVUs for 88360PPRRVU2026_Oct_nonQPP.csv, line 11,275 (RVU26D)

Open CMS sourceHow we calculate rates

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