$86.97
88161 includes preparation of the smear in addition to screening and interpretation. 88160 is the closer fit when the laboratory screens and interprets a smear without performing that preparation.
On this page
CMS RVU26D · Effective 2026-10-01
88161 Cytology smear Medicare reimbursement rates in Connecticut
Reports laboratory preparation, screening, and interpretation of cytology smears from non-gynecologic sources, such as sputum or urine specimens. Compare 88161 office and facility rates across CMS payment localities in Connecticut.
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 88161 in Connecticut?
Connecticut 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
$88.41
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 88161: Non-gynecologic smear preparation and review
Reports laboratory preparation, screening, and interpretation of cytology smears from non-gynecologic sources, such as sputum or urine specimens.
This service covers making cytology smears from a non-gynecologic specimen and examining them for cellular abnormalities, with interpretation and a report. A cytotechnologist commonly performs the technical preparation and screening, with a pathologist providing professional interpretation. Specimens may include sputum or urine; cervical and vaginal specimens use their own code family. The service may be performed in a hospital or independent pathology laboratory.
Choose this code when the laboratory prepares the smear as well as screens and interprets it. The record should identify the specimen source and support the preparation and cytologic evaluation performed. CMS recognizes separate professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff work, and billing without either modifier represents the global service.
CMS billing rules for 88161
- 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 RVU0.49 · 20%
- Practice expense (office) RVU1.96 · 79%
- Malpractice RVU0.03 · 1%
4.3K
Medicare services in 2024 · #1968 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.
88161 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$136.18
88162 describes a manual-screening pathway under physician supervision. 88161 is selected for the service that includes smear preparation, screening, and interpretation.
88142
No office rateCytopath c/v thin layer
88142 is for cervical or vaginal cytology. 88161 is for smears from other sources, such as sputum or urine.
$73.37
88108 is for cytology using a concentration technique on fluids, washings, or brushings. 88161 applies when the service is smear preparation, screening, and interpretation rather than that concentration method.
Compare 88161 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
Connecticut →
Office / nonfacility
$88.41
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 88161 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
11,138
- Code
- 88161
- Physician work
- 0.49
- Practice expense
- 1.96
- Malpractice
- 0.03
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.49 | × 1.020 | 0.4998 |
| Practice expense | 1.96 | × 1.077 | 2.1109 |
| Malpractice | 0.03 | × 1.210 | 0.0363 |
| Total RVUs | 2.6470 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$88.41
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.49 | 1.02 |
| Practice expense | 1.96 | 1.077 |
| Malpractice | 0.03 | 1.21 |
(0.49 × 1.02 + 1.96 × 1.077 + 0.03 × 1.21) × $33.4009 = $88.41
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.
88161 billing questions
How does this differ from 88160?
88161 includes laboratory preparation of the smear as well as screening and interpretation. Use 88160 when the service is screening and interpretation without the preparation included in 88161.
Is slide preparation included?
Yes. Preparation of the smear, screening, and interpretation are part of this service; do not separately report the smear preparation as a second service under this code.
Can the professional and technical work be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical work, including equipment and staff. Without either modifier, the claim represents the global service.
Can this code be used for a Pap smear?
No. Cervical and vaginal cytology belongs to the cervicovaginal code family, such as 88142, rather than the other-source smear family.
What should the documentation identify?
Document the specimen source and the smear preparation, screening, and interpretation performed. That information supports distinguishing this service from screening and interpretation of an already-prepared smear.
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.
11,13588160,,Cytopath smear other source,A,,0.49,1.92,,1.92,NA,0.03,2.44,2.44,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,13688160,26,Cytopath smear other source,A,,0.49,0.22,,0.22,,0.01,0.72,0.72,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,13788160,TC,Cytopath smear other source,A,,0.00,1.70,,1.70,NA,0.02,1.72,1.72,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,13888161,,Cytopath smear other source,A,,0.49,1.96,,1.96,NA,0.03,2.48,2.48,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,13988161,26,Cytopath smear other source,A,,0.49,0.22,,0.22,,0.01,0.72,0.72,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,14088161,TC,Cytopath smear other source,A,,0.00,1.74,,1.74,NA,0.02,1.76,1.76,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,14188162,,Cytopath smear other source,A,,0.74,3.04,,3.04,NA,0.04,3.82,3.82,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808