Billing code 88161: Cytology smearMedicare rate & RVUs in Texas
Reports laboratory preparation, screening, and interpretation of cytology smears from non-gynecologic sources, such as sputum or urine specimens.
Medicare pays $76.87–$86.55 for 88161 in the office in Texas, from Beaumont to Austin. 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 88161 covers
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.
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 88161 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$76.87 to $86.55
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $86.55 | Unavailable |
| Beaumont | $76.87 | Unavailable |
| Brazoria | $82.16 | Unavailable |
| Dallas | $82.58 | Unavailable |
| Fort Worth | $81.94 | Unavailable |
| Galveston | $82.33 | Unavailable |
| Houston | $82.88 | Unavailable |
| Rest Of Texas | $79.40 | Unavailable |
How the 88161 rate is calculated
Each of 88161’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 · 88161
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.49Practice expense 1.96Malpractice 0.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 88161
The CMS indicators that decide how 88161 is paid alongside other services.
CMS payment indicators · 88161
Cytology smear
| 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
88161 without 26 · national office
$82.83
Cytology smear
88161-26 · Professional component
$24.05
Pays only the interpretation and report.
88161 compared with similar codes
Compare codes
88161 vs 88160 vs 88162 vs 88142 vs 88108: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 88160Cytology smear
- 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.
- 88162Cytopathology smear
- 88162 describes a manual-screening pathway under physician supervision. 88161 is selected for the service that includes smear preparation, screening, and interpretation.
- 88142Cytopath c/v thin layer
- 88142 is for cervical or vaginal cytology. 88161 is for smears from other sources, such as sputum or urine.
- 88108Concentrated cytology
- 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.
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 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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