Billing code 88360: Tumor IHC scoringMedicare rate & RVUs in Florida
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.
Medicare pays $116.54–$125.03 for 88360 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$116.54 to $125.03
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $121.98 | Unavailable |
| Miami | $125.03 | Unavailable |
| Rest Of Florida | $116.54 | Unavailable |
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
Swap in your local Medicare rate.
Work 0.83Practice expense 2.75Malpractice 0.02
All indexes start 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
88360 compared with similar codes
Compare codes
88360 vs 88361 vs 88342 vs 88341: national Medicare rates
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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
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