$151.00
Choose 88172 for the immediate adequacy assessment during aspiration; choose 88173 for the diagnostic interpretation and report.
On this page
CMS RVU26D · Effective 2026-10-01
88172 FNA adequacy Medicare reimbursement rates in Alabama
Reports immediate cytopathology review of fine needle aspirate material at the first site to assess specimen adequacy during an aspiration procedure. Compare 88172 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 88172 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$49.94
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Cytopathology
About 88172: Fine needle aspirate adequacy evaluation
Reports immediate cytopathology review of fine needle aspirate material at the first site to assess specimen adequacy during an aspiration procedure.
This service is an immediate review of material collected by fine needle aspiration to determine whether the specimen is adequate for diagnostic work. It is commonly performed during aspiration of a thyroid nodule, lymph node, or other mass, with a cytopathologist or pathology team reviewing the material while the procedure is in progress. The adequacy assessment can help the proceduralist decide whether further passes or specimen triage are needed.
Report 88172 for the first site evaluated; additional sites are represented by 88177 rather than by counting repeat passes from the same site as new sites. Documentation should identify the aspirated site and record the on-site adequacy assessment. This service is distinct from the final diagnostic interpretation and report represented by 88173 when that work is also performed. CMS recognizes professional and technical components: modifier 26 reports interpretation, modifier TC reports equipment and staff, and billing without either modifier represents the global service.
CMS billing rules for 88172
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU0.67 · 41%
- Practice expense (office) RVU0.93 · 57%
- Malpractice RVU0.02 · 1%
117.4K
Medicare services in 2024 · #517 by national volume
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.
88172 compared with similar codes
Office rates for Alabama, from the same CMS release.
$27.04
88172 is for the first site evaluated. Use 88177 for each additional site, not for extra passes at the original site.
$73.05
88160 concerns cytology smears from other sources; 88172 is specifically immediate adequacy evaluation of fine needle aspirate material.
Compare 88172 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$49.94
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 88172 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
11,148
- Code
- 88172
- Physician work
- 0.67
- Practice expense
- 0.93
- Malpractice
- 0.02
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.67 | × 1.000 | 0.6700 |
| Practice expense | 0.93 | × 0.875 | 0.8138 |
| Malpractice | 0.02 | × 0.566 | 0.0113 |
| Total RVUs | 1.4951 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$49.94
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.67 | 1 |
| Practice expense | 0.93 | 0.875 |
| Malpractice | 0.02 | 0.566 |
(0.67 × 1 + 0.93 × 0.875 + 0.02 × 0.566) × $33.4009 = $49.94
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
88172 billing questions
How is 88172 different from 88173?
88172 represents immediate review to assess specimen adequacy during the aspiration procedure. 88173 represents the diagnostic interpretation and report.
When is 88177 reported with 88172?
88172 covers the first site evaluated, and 88177 is the add-on for each additional site. Additional passes from the same site do not make it an additional site.
Can 88172 be reported with the FNA procedure?
Yes, when immediate cytopathology adequacy evaluation is performed in addition to the aspiration procedure. The aspiration code describes collecting the specimen; 88172 describes its on-site adequacy review.
Which modifiers identify the components?
Use modifier 26 for the professional interpretation or modifier TC for the technical work, including equipment and staff. Without either modifier, 88172 represents the global service.
What documentation supports 88172?
Document the site evaluated and the immediate adequacy assessment. The record should support that cytopathology review occurred during the aspiration, rather than only a later diagnostic interpretation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,14588165,,Cytopath tbs c/v redo,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,14688166,,Cytopath tbs c/v auto redo,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,14788167,,Cytopath tbs c/v select,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,14888172,,Cytp dx eval fna 1st ea site,A,,0.67,0.93,,0.93,NA,0.02,1.62,1.62,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,14988172,26,Cytp dx eval fna 1st ea site,A,,0.67,0.31,,0.31,,0.01,0.99,0.99,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,15088172,TC,Cytp dx eval fna 1st ea site,A,,0.00,0.62,,0.62,NA,0.01,0.63,0.63,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,15188173,,Cytopath eval fna report,A,,1.36,3.58,,3.58,NA,0.05,4.99,4.99,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515