$574.29
Choose 88121 when the urinary in situ hybridization analysis is computer-assisted. 88120 describes the corresponding three-to-five-probe service without computer assistance.
On this page
CMS RVU26D · Effective 2026-10-01
88121 Urine FISH Medicare reimbursement rates in Colorado
Computer-assisted in situ hybridization evaluates urinary tract cells with three to five probes, typically supporting assessment or surveillance for urothelial carcinoma. Compare 88121 office and facility rates across CMS payment localities in Colorado.
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 88121 in Colorado?
Colorado 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
$416.92
1 of 1 localities have a supported rate.
Payment area: Colorado
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 88121: Computer-assisted urinary FISH analysis
Computer-assisted in situ hybridization evaluates urinary tract cells with three to five probes, typically supporting assessment or surveillance for urothelial carcinoma.
88121 represents computer-assisted cytopathologic analysis of a urinary tract specimen using in situ hybridization with a panel of three to five probes. The method evaluates probe signals in urothelial cells for chromosomal changes associated with urothelial carcinoma; it may be used when evaluating hematuria or monitoring a patient with a history of bladder cancer. Laboratory staff prepare and analyze the specimen, with a pathologist or other qualified professional interpreting the findings. Pathology and molecular diagnostic laboratories commonly perform this service.
Report one unit for each specimen examined. Documentation should identify the urinary specimen, the probe panel and count, the computer-assisted method, and the interpretation. This distinguishes 88121 from 88120, which describes the corresponding service without computer assistance. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.
CMS billing rules for 88121
- 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 RVU0.98 · 8%
- Practice expense (office) RVU10.77 · 91%
- Malpractice RVU0.04 · 0%
21.5K
Medicare services in 2024 · #1118 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.
88121 compared with similar codes
Office rates for Colorado, from the same CMS release.
$68.51
88112 is a cell-enhanced cytology examination focused on cell morphology. 88121 is a probe-based molecular analysis of a urinary tract specimen.
$88.32
88104 reports morphologic examination of a fluid or washing smear. 88121 reports computer-assisted in situ hybridization with three to five probes.
Compare 88121 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
Colorado →
Office / nonfacility
$416.92
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 88121 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
11,118
- Code
- 88121
- Physician work
- 0.98
- Practice expense
- 10.77
- Malpractice
- 0.04
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.98 | × 1.012 | 0.9918 |
| Practice expense | 10.77 | × 1.064 | 11.4593 |
| Malpractice | 0.04 | × 0.781 | 0.0312 |
| Total RVUs | 12.4823 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$416.92
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1.012 |
| Practice expense | 10.77 | 1.064 |
| Malpractice | 0.04 | 0.781 |
(0.98 × 1.012 + 10.77 × 1.064 + 0.04 × 0.781) × $33.4009 = $416.92
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.
88121 billing questions
How does 88121 differ from 88120?
Both involve urinary tract specimens and three to five probes. 88121 is the computer-assisted service; 88120 is the corresponding service without computer assistance.
How many units should be reported?
Report one unit for each specimen examined. The three-to-five-probe range describes the panel for the service, not the number of units.
Which modifiers identify the components?
Use modifier 26 for the professional interpretation and modifier TC for the technical service involving equipment and staff. Without either modifier, the claim represents the global service.
Can 88121 be reported with conventional urine cytology?
88121 represents molecular in situ hybridization, while conventional cytology evaluates cell morphology. Report both only when both distinct services were performed and documented.
What documentation supports reporting 88121?
Record the urinary tract specimen, the computer-assisted in situ hybridization method, the three-to-five-probe panel, and the professional interpretation when that component is billed.
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.
11,11588120,,Cytp urne 3-5 probes ea spec,A,,1.17,15.01,,15.01,NA,0.05,16.23,16.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,11688120,26,Cytp urne 3-5 probes ea spec,A,,1.17,0.44,,0.44,,0.02,1.63,1.63,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,11788120,TC,Cytp urne 3-5 probes ea spec,A,,0.00,14.57,,14.57,NA,0.03,14.60,14.60,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,11888121,,Cytp urine 3-5 probes cmptr,A,,0.98,10.77,,10.77,NA,0.04,11.79,11.79,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,11988121,26,Cytp urine 3-5 probes cmptr,A,,0.98,0.36,,0.36,,0.02,1.36,1.36,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,12088121,TC,Cytp urine 3-5 probes cmptr,A,,0.00,10.41,,10.41,NA,0.02,10.43,10.43,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,12188125,,Forensic cytopathology,A,,0.25,0.56,,0.56,NA,0.02,0.83,0.83,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899