Billing code 88172: FNA adequacyMedicare rate & RVUs in Oklahoma
Reports immediate cytopathology review of fine needle aspirate material at the first site to assess specimen adequacy during an aspiration procedure.
Medicare pays $50.64 for 88172 in the office in Oklahoma (Oklahoma). 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 88172 covers
This service is an immediate review of material collected by fine needle aspiration to determine whether the specimen is adequate for diagnostic work. It is commonly performed during aspiration of a thyroid nodule, lymph node, or other mass, with a cytopathologist or pathology team reviewing the material while the procedure is in progress. The adequacy assessment can help the proceduralist decide whether further passes or specimen triage are needed.
Report 88172 for the first site evaluated; additional sites are represented by 88177 rather than by counting repeat passes from the same site as new sites. Documentation should identify the aspirated site and record the on-site adequacy assessment. This service is distinct from the final diagnostic interpretation and report represented by 88173 when that work is also performed. CMS recognizes professional and technical components: modifier 26 reports interpretation, modifier TC reports equipment and staff, and billing without either modifier represents the global service.
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.
88172 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $50.64 | Unavailable |
How the 88172 rate is calculated
Each of 88172’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 · 88172
RVUs × geographic indexes × conversion factor
Work0.67
0.67 RVUs× 1.000 GPCI
Practice expense0.93
0.93 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.6200
Conversion factor
$33.4009
Medicare rate
$54.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 88172
The CMS indicators that decide how 88172 is paid alongside other services.
CMS payment indicators · 88172
FNA adequacy
| 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
88172 without 26 · national office
$54.11
FNA adequacy
88172-26 · Professional component
$33.07
Pays only the interpretation and report.
88172 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 88173FNA cytology
- Choose 88172 for the immediate adequacy assessment during aspiration; choose 88173 for the diagnostic interpretation and report.
- 88177FNA adequacy
- 88172 is for the first site evaluated. Use 88177 for each additional site, not for extra passes at the original site.
- 88160Cytology smear
- 88160 concerns cytology smears from other sources; 88172 is specifically immediate adequacy evaluation of fine needle aspirate material.
88172 billing questions
How is 88172 different from 88173?
88172 represents immediate review to assess specimen adequacy during the aspiration procedure. 88173 represents the diagnostic interpretation and report.
When is 88177 reported with 88172?
88172 covers the first site evaluated, and 88177 is the add-on for each additional site. Additional passes from the same site do not make it an additional site.
Can 88172 be reported with the FNA procedure?
Yes, when immediate cytopathology adequacy evaluation is performed in addition to the aspiration procedure. The aspiration code describes collecting the specimen; 88172 describes its on-site adequacy review.
Which modifiers identify the components?
Use modifier 26 for the professional interpretation or modifier TC for the technical work, including equipment and staff. Without either modifier, 88172 represents the global service.
What documentation supports 88172?
Document the site evaluated and the immediate adequacy assessment. The record should support that cytopathology review occurred during the aspiration, rather than only a later diagnostic interpretation.
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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