$78.27–$87.85
88104 is for routine non-gynecologic fluid smear cytology. Choose 88125 when the cytologic examination is performed for a forensic question.
On this page
CMS RVU26D · Effective 2026-10-01
88125 Forensic cytology Medicare reimbursement rates in Texas
Reports cytologic examination of material submitted for a forensic question, such as body fluid or hair evidence in a legal investigation. Compare 88125 office and facility rates across CMS payment localities in Texas.
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 88125 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$25.99–$28.75
8 of 8 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.
Where 88125 pays more and less in Texas
8 payment localities
$25.99 to $28.75
Cytopathology
About 88125: Forensic cytology examination
Reports cytologic examination of material submitted for a forensic question, such as body fluid or hair evidence in a legal investigation.
88125 covers cytologic examination of material submitted for a forensic question rather than routine diagnosis of a patient’s disease. The material may include body fluids or hair, examples associated with forensic cytopathology. A pathologist evaluates the submitted material, while laboratory personnel may perform technical preparation and processing. The work may take place in a pathology or forensic laboratory when material is examined as evidence in a legal investigation.
Select this code based on the forensic purpose, not merely the specimen source: fluid submitted for routine non-gynecologic cytology follows its routine cytopathology pathway, while a forensic submission supports 88125. Documentation should identify the material, forensic context, examination performed, and interpreting professional. CMS recognizes global billing or separate professional and technical portions: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and no modifier represents the global service.
CMS billing rules for 88125
- 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 RVU0.25 · 30%
- Practice expense (office) RVU0.56 · 67%
- Malpractice RVU0.02 · 2%
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.
88125 compared with similar codes
Office rates for Texas, from the same CMS release.
$63.92–$71.88
88108 describes routine cytopathology using a concentration technique. 88125 is distinguished by the forensic purpose of examining the submitted material.
$75.66–$85.14
88160 covers routine smear cytopathology from another source. 88125 applies when the material is examined as forensic evidence.
Compare 88125 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $28.75 | Facility Unavailable |
| Beaumont | Office $25.99 | Facility Unavailable |
| Brazoria | Office $27.47 | Facility Unavailable |
| Dallas | Office $27.63 | Facility Unavailable |
| Fort Worth | Office $27.45 | Facility Unavailable |
| Galveston | Office $27.54 | Facility Unavailable |
| Houston | Office $27.91 | Facility Unavailable |
| Rest Of Texas | Office $26.70 | 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.
88125 billing questions
When should 88125 be chosen over routine cytopathology?
Use 88125 when material is examined for a forensic question, such as legal evidence analysis. A similar specimen source alone does not make a routine diagnostic cytology service forensic.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion involving equipment and staff. Billing without either modifier represents the global service.
What documentation supports reporting 88125?
Document the submitted material, the forensic context or question, the cytologic examination performed, and the professional responsible for interpretation.
Does the specimen source alone determine whether 88125 applies?
No. The forensic purpose distinguishes this service from routine cytopathology on a similar specimen, such as a fluid evaluated for ordinary diagnostic care.
Can a laboratory report 88125 without a modifier?
Yes. CMS identifies unmodified billing as the global service, combining the professional interpretation and technical service.
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.
11,11888121,,Cytp urine 3-5 probes cmptr,A,,0.98,10.77,,10.77,NA,0.04,11.79,11.79,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,11988121,26,Cytp urine 3-5 probes cmptr,A,,0.98,0.36,,0.36,,0.02,1.36,1.36,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,12088121,TC,Cytp urine 3-5 probes cmptr,A,,0.00,10.41,,10.41,NA,0.02,10.43,10.43,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,12188125,,Forensic cytopathology,A,,0.25,0.56,,0.56,NA,0.02,0.83,0.83,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,12288125,26,Forensic cytopathology,A,,0.25,0.12,,0.12,,0.01,0.38,0.38,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,12388125,TC,Forensic cytopathology,A,,0.00,0.44,,0.44,NA,0.01,0.45,0.45,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,12488130,,Sex chromatin identification,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00