Billing code 88367: ISH analysisMedicare rate & RVUs in Illinois
Automated morphometric analysis of in situ hybridization signals in tissue helps quantify or assess a molecular finding, such as tumor gene amplification.
Medicare pays $98.25–$107.73 for 88367 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. 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 88367 covers
This service covers automated morphometric analysis of in situ hybridization signals in a tissue specimen. A pathology laboratory uses imaging equipment and software to assess signal patterns, while a pathologist interprets the findings in the clinical and morphologic context. A familiar application is evaluating HER2 gene amplification in tumor tissue, including breast or gastric specimens, when the assay and analysis method support this code. It represents image-based analysis, not simply the preparation or staining of a probe slide.
Select the code based on the documented analysis method and the applicable billing code distinction between automated and manual analysis. The record should support the specimen analyzed, the in situ hybridization method, the automated analysis performed, and the pathologist’s interpretation. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff, or neither modifier when billing the global service. The CMS fee schedule prices modifiers 26 and TC separately.
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 88367 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$98.25 to $107.73
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $106.31 | Unavailable |
| East St. Louis | $99.12 | Unavailable |
| Rest Of Illinois | $98.25 | Unavailable |
| Suburban Chicago | $107.73 | Unavailable |
How the 88367 rate is calculated
Each of 88367’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 · 88367
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.71Practice expense 2.41Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 88367
The CMS indicators that decide how 88367 is paid alongside other services.
CMS payment indicators · 88367
ISH analysis
| 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
88367 without 26 · national office
$104.88
ISH analysis
88367-26 · Professional component
$31.06
Pays only the interpretation and report.
88367 compared with similar codes
Compare codes
88367 vs 88368 vs 88369 vs 88373 vs 88364: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 88368ISH analysis
- 88368 is the manual morphometric analysis counterpart; 88367 is used when the analysis is automated.
- 88369ISH morphometry
- 88369 describes manual quantitative or semiquantitative morphometric analysis, rather than the automated analysis represented by 88367.
- 88373ISH analysis
- 88373 is for automated quantitative or semiquantitative morphometric analysis; 88367 is the automated morphometric analysis code without that specific quantitative or semiquantitative distinction.
- 88364ISH probe stain
- 88364 represents the initial single-probe in situ hybridization stain procedure, not automated morphometric analysis of the resulting signals.
88367 billing questions
How does this differ from 88368?
88367 represents automated morphometric analysis of in situ hybridization signals. Use 88368 when the morphometric analysis is performed manually.
Is this code for the probe stain itself?
No. It represents automated morphometric analysis of the in situ hybridization signals, rather than the probe stain procedure alone.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Report the global service without either modifier.
What documentation supports reporting 88367?
Document the tissue specimen, in situ hybridization method, automated morphometric analysis performed, and the pathologist’s interpretation.
Is the unit based on the slide or the specimen?
The code is described per specimen. The report should identify the specimen analyzed rather than treating each image or slide as a separate unit automatically.
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
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