Billing code 88104: Fluid cytologyMedicare rate & RVUs in Alaska

Reports cytologic examination and interpretation of direct smears made from non-gynecologic fluids, washings, or brushings, such as pleural fluid or bronchial washings.

CMS RVU26DEffective Oct 1, 20261 payment locality27.6K Medicare services in 2024

Medicare pays $97.12 for 88104 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$97.12Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 88104 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What 88104 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 88104 covers

This service covers cytologic examination of direct smears prepared from non-gynecologic fluids, washings, or brushings. Examples include pleural or peritoneal fluid, cerebrospinal fluid, and bronchial washings or brushings. Laboratory staff prepare and stain the slides, and a cytopathologist or other qualified physician examines the cells and provides the interpretation. The findings may help evaluate a specimen for malignant or other abnormal cells.

Choose this code when the specimen is examined as a smear rather than processed by a filtration, concentration, or cellular-enhancement method. The report should identify the specimen source and include the cytologic findings and physician interpretation. Medicare recognizes professional and technical components: modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff work. Reporting without either modifier represents the combined 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.

88104 in Alaska*

88104 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$97.12Unavailable

How the 88104 rate is calculated

Each of 88104’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 · 88104

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.55Practice expense 1.94Malpractice 0.03

2.5200 adjusted RVUs×$33.4009 conversion factor=$84.17

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 88104

The CMS indicators that decide how 88104 is paid alongside other services.

CMS payment indicators · 88104

Fluid cytology

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

88104 without 26 · national office

$84.17

Fluid cytology

88104-26 · Professional component

$26.72

Pays only the interpretation and report.

When to use modifier 26

88104 compared with similar codes

Compare codes

88104 vs 88106 vs 88108 vs 88112: national Medicare rates

Swap in your local Medicare rate.

  • 88104
    Fluid cytology · 0.55 wRVU
    $84.17
  • 88106
    Fluid cytology · 0.36 wRVU
    $67.47−$16.70
  • 88108
    Concentrated cytology · 0.43 wRVU
    $68.81−$15.36
  • 88112
    Selective-enhancement cytology · 0.55 wRVU
    $65.47−$18.70

How to choose

88106Fluid cytology
88104 is for direct smears. Choose 88106 when the non-gynecologic specimen is prepared using filtration.
88108Concentrated cytology
88104 covers direct-smear preparation; 88108 is used when a concentration technique is used to prepare the specimen.
88112Selective-enhancement cytology
Use 88112 for a non-gynecologic specimen prepared with a selective cellular-enhancement method, rather than as a direct smear.

88104 billing questions

When should 88104 be chosen instead of 88108?

Use 88104 for a direct smear of a non-gynecologic fluid, washing, or brushing. Use 88108 when the specimen is processed using a concentration technique.

Does 88104 include the physician's interpretation?

Yes. The service includes interpretation; modifier 26 reports the professional component alone, while modifier TC reports the technical component alone.

What does the technical component cover?

The technical component represents the equipment and staff work involved in the service. Modifier TC identifies that portion.

Can 88104 be reported for a cervical or vaginal smear?

No. This code is for non-gynecologic fluid, washing, or brushing smears; cervical and vaginal cytology uses the applicable gynecologic cytopathology code.

What specimen details should the report include?

Document the source and type of specimen, the smear preparation, and the cytologic findings with the physician's 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 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 88104PPRRVU2026_Oct_nonQPP.csv, line 11,103 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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