CPT 88121 - FindACode.com

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Fees

Calculated for UT (84043)

* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.

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Facility (Hospital, etc.)

Medicare vs. My Fee Evaluation

Modifier	Medicare Allowed	150%	200%	My Fee
(none)	$514.22	$771.33	$1,028.44	(your fee)
26	$48.24	$72.36	$96.47	(your fee)
TC	$465.98	$698.97	$931.96	(your fee)

Note: Subscribers with the Hospital/Facility product will see calculated values below.

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Medicare Participating - Assignment Accepted (Mandatory)

Modifier	Allowed	Medicare 80%	Patient Pays
(none)	$514.22	$##.##	$##.##
26	$48.24	$##.##	$##.##
TC	$465.98	$##.##	$##.##

Medicare Non-Participating - Assignment Accepted (Check To Doctor)

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##
26	$##.##	$##.##	$##.##	$##.##
TC	$##.##	$##.##	$##.##	$##.##

Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##
26	$##.##	$##.##	$##.##	$##.##
TC	$##.##	$##.##	$##.##	$##.##

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Non-Facility (Office, etc.)

Medicare vs. My Fee Evaluation

Modifier	Medicare Allowed	150%	200%	My Fee
(none)	$514.22	$771.33	$1,028.44	(your fee)
26	$48.24	$72.36	$96.47	(your fee)
TC	$465.98	$698.97	$931.96	(your fee)

Note: Subscribers will see the calculated values below.

Find-A-Code subscribers: Sign In to your account to see this information.

Or Subscribe to Find-A-Code today for instant access to all the coding information you need.

Medicare Participating - Assignment Accepted (Mandatory)

Modifier	Allowed	Medicare 80%	Patient Pays
(none)	$514.22	$##.##	$##.##
26	$48.24	$##.##	$##.##
TC	$465.98	$##.##	$##.##

Medicare Non-Participating - Assignment Accepted (Check To Doctor)

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##
26	$##.##	$##.##	$##.##	$##.##
TC	$##.##	$##.##	$##.##	$##.##

Medicare Non-Participating - Assignment NOT Accepted (Check To Patient)

Modifier	Allowed	Medicare 80%	Patient Pays	Limiting Charge (Amount Billed)
(none)	$##.##	$##.##	$##.##	$##.##
26	$##.##	$##.##	$##.##	$##.##
TC	$##.##	$##.##	$##.##	$##.##

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APC Fee Information

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RVUs - Relative Value Units

Calculated for UT (84043)

* Note: Medicare may or may NOT reimburse you for this code. The fees provided below are based on values established by CMS/Medicare. Please check with your local Medicare contact on whether this code is eligible for reimbursement.

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Facility 15.11 (Hospital, etc.)

RVU Components (by modifier)

Modifier	Work	Practice Expense	Malpractice Expense	Total
(none)	1	14.07	0.04	15.11
26	1	0.38	0.03	1.42
TC	0	13.69	0.01	13.7

Practitioner Work Component: 1

Pre-Service	Intra-Service	Post-Service	Total Time*
##	##	##	## min

Modifier	National Unadjusted Work RVU	Work GPCI	Adjusted Work RVU
(none)	##.##	##.##	1
26	##.##	##.##	1
TC	##.##	##.##	0

Practice Expense: 14.07

Clinical Labor - Direct Expense

Staff	Staff Rate	Pre Time	Intra Time	Post Time	Total Time*
Medical/Technical Assistant	.26 / min	## min	## min	## min	## min
Lab Technician	.33 / min	## min	## min	## min	## min
Cytotechnologist	.45 / min	## min	## min	## min	## min

* Total Time may be greater than the displayed components.

Equipment - Direct Expense

Item	Purchase Price	Expected Life	Total Time
centrifuge (with rotor)	$##.##	## years	## min
cytology thinlayer processor (ThinPrep)	$##.##	## years	## min
hood, ventilator with blower	$##.##	## years	## min
pH conductivity meter	$##.##	## years	## min
vacuum pump	$##.##	## years	## min
microfuge, benchtop	$##.##	## years	## min
water bath, FISH procedures (lab)	$##.##	## years	## min
ThermoBrite	$##.##	## years	## min
Camera (Olympus DP21)	$##.##	## years	## min
IkoniLan Software	$##.##	## years	## min
IkoniScope	$##.##	## years	## min

Supplies - Direct Expense

Item	Unit Price	Quantity	Unit	Amount
ThinPrep UroCyte Urine Collection Kit	$##.##	##	kit	$##.##
UroVysion test kit	$##.##	##	item	$##.##
gloves, non-sterile, nitrile	$##.##	##	pair	$##.##
gown, staff, impervious	$##.##	##	item	$##.##
mask, surgical	$##.##	##	item	$##.##
syringe 5-6ml	$##.##	##	item	$##.##
rubber cement	$##.##	##	ml	$##.##
centrifuge tube	$##.##	##	item	$##.##
cover slip, glass	$##.##	##	item	$##.##
cytology, lysing soln (CytoLyt)	$##.##	##	ml	$##.##
cytology, preservative and vial (Preserv-cyt)	$##.##	##	item	$##.##
fixative processing (buffered formalin)	$##.##	##	ml	$##.##
formalin	$##.##	##	ml	$##.##
immersion oil	$##.##	##	ml	$##.##
1.0N NaOH	$##.##	##	ml	$##.##
pipette tips, sterile	$##.##	##	item	$##.##
ethanol, 100%	$##.##	##	ml	$##.##
ethanol, 70%	$##.##	##	ml	$##.##
ethanol, 85%	$##.##	##	ml	$##.##
water, de-ionized	$##.##	##	ml	$##.##
ethanol, 95%	$##.##	##	ml	$##.##
Non-Gyn Filter unit	$##.##	##	item	$##.##
0.45 ?m pore filtration unit	$##.##	##	item	$##.##
12-well slides	$##.##	##	item	$##.##
ThinPrep UroCyte filter	$##.##	##	item	$##.##
Humidity cards	$##.##	##	item	$##.##
Control slides	$##.##	##	kit	$##.##
Bleach cleaning wipe	$##.##	##	item	$##.##
Fresh Fixative (3:1, methanol: acetic acid)	$##.##	##	item	$##.##
FISH pre-treatment kit	$##.##	##	kit	$##.##
biohazard specimen transport bag	$##.##	##	item	$##.##
eye shield, splash protection	$##.##	##	item	$##.##

Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.

PE RVU Components (by modifier)

Modifier	National Unadjusted PE RVU	PE GPCI	Adjusted PE RVU
(none)	##.##	##.##	14.07
26	##.##	##.##	0.38
TC	##.##	##.##	13.69

Malpractice Component: 0.04

Modifier	National Unadjusted MP RVU	MP GPCI	Adjusted MP RVU
(none)	##.##	##.##	0.04
26	##.##	##.##	0.03
TC	##.##	##.##	0.01

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Non-Facility 15.11 (Office, etc.)

RVU Components (by modifier)

Modifier	Work	Practice Expense	Malpractice Expense	Total
(none)	1	14.07	0.04	15.11
26	1	0.38	0.03	1.42
TC	0	13.69	0.01	13.7

Practitioner Work Component: 1

Pre-Service	Intra-Service	Post-Service	Total Time*
##	##	##	## min

Modifier	National Unadjusted Work RVU	Work GPCI	Adjusted Work RVU
(none)	##.##	##.##	1
26	##.##	##.##	1
TC	##.##	##.##	0

Practice Expense: 14.07

Clinical Labor (Non-Facility)- Direct Expense

Staff	Staff Rate	Pre Time	Intra Time	Post Time	Total Time*
Medical/Technical Assistant	.26 / min	## min	## min	## min	## min
Lab Technician	.33 / min	## min	## min	## min	## min
Cytotechnologist	.45 / min	## min	## min	## min	## min

* Total Time may be greater than the displayed components.

Equipment (Non-Facility)- Direct Expense

Item	Purchase Price	Expected Life	Total Time
centrifuge (with rotor)	$##.##	## years	## min
cytology thinlayer processor (ThinPrep)	$##.##	## years	## min
hood, ventilator with blower	$##.##	## years	## min
pH conductivity meter	$##.##	## years	## min
vacuum pump	$##.##	## years	## min
microfuge, benchtop	$##.##	## years	## min
water bath, FISH procedures (lab)	$##.##	## years	## min
ThermoBrite	$##.##	## years	## min
Camera (Olympus DP21)	$##.##	## years	## min
IkoniLan Software	$##.##	## years	## min
IkoniScope	$##.##	## years	## min

Supplies (Non-Facility)- Direct Expense

Item	Unit Price	Quantity	Unit	Amount
ThinPrep UroCyte Urine Collection Kit	$##.##	##	kit	$##.##
UroVysion test kit	$##.##	##	item	$##.##
gloves, non-sterile, nitrile	$##.##	##	pair	$##.##
gown, staff, impervious	$##.##	##	item	$##.##
mask, surgical	$##.##	##	item	$##.##
syringe 5-6ml	$##.##	##	item	$##.##
rubber cement	$##.##	##	ml	$##.##
centrifuge tube	$##.##	##	item	$##.##
cover slip, glass	$##.##	##	item	$##.##
cytology, lysing soln (CytoLyt)	$##.##	##	ml	$##.##
cytology, preservative and vial (Preserv-cyt)	$##.##	##	item	$##.##
fixative processing (buffered formalin)	$##.##	##	ml	$##.##
formalin	$##.##	##	ml	$##.##
immersion oil	$##.##	##	ml	$##.##
1.0N NaOH	$##.##	##	ml	$##.##
pipette tips, sterile	$##.##	##	item	$##.##
ethanol, 100%	$##.##	##	ml	$##.##
ethanol, 70%	$##.##	##	ml	$##.##
ethanol, 85%	$##.##	##	ml	$##.##
water, de-ionized	$##.##	##	ml	$##.##
ethanol, 95%	$##.##	##	ml	$##.##
Non-Gyn Filter unit	$##.##	##	item	$##.##
0.45 ?m pore filtration unit	$##.##	##	item	$##.##
12-well slides	$##.##	##	item	$##.##
ThinPrep UroCyte filter	$##.##	##	item	$##.##
Humidity cards	$##.##	##	item	$##.##
Control slides	$##.##	##	kit	$##.##
Bleach cleaning wipe	$##.##	##	item	$##.##
Fresh Fixative (3:1, methanol: acetic acid)	$##.##	##	item	$##.##
FISH pre-treatment kit	$##.##	##	kit	$##.##
biohazard specimen transport bag	$##.##	##	item	$##.##
eye shield, splash protection	$##.##	##	item	$##.##

Indirect Expenses (clerical,overhead, and other) are also included in the practice expense.

PE RVU Components (by modifier)

Modifier	National Unadjusted PE RVU	PE GPCI	Adjusted PE RVU
(none)	##.##	##.##	14.07
26	##.##	##.##	0.38
TC	##.##	##.##	13.69

Malpractice Component: 0.04

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CPT^{^®} Code Set - 88121