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 New Jersey
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 New Jersey.
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 New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$89.61–$94.41
2 of 2 localities have a supported rate.
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 New Jersey, from the same CMS release.
88162 describes a manual-screening pathway under physician supervision. 88161 is selected for the service that includes smear preparation, screening, and interpretation.
Cytopath c/v thin layer
88142 is for cervical or vaginal cytology. 88161 is for smears from other sources, such as sputum or urine.
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.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
$94.41
Facility
Unavailable
Rest Of New Jersey →
Office / nonfacility
$89.61
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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.
