CPT 88342 Medicare payment status

Payment rules for 88342 Copy link

Global period: what 88342's fee already covers Copy link

The global surgery concept does not apply to this code.

Billing policy Copy link

These billing-policy indicators explain how 88342 is treated. They apply whether the code is nationally priced or carrier-priced: a restriction like "bilateral not allowed" still matters on a carrier-priced code.

Check a pair of codes Copy link

Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit for the pair.

See every current NCCI pair for 88342 →

Why a 88342 line may not pay separately Copy link

CMS publishes no separately payable amount for 88342 in this release, so reconciling the line means establishing which status governed the date of service rather than chasing a fee-schedule difference.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); CMS Medicare Claims Processing Manual (Pub. 100-04); 42 USC 1395w-4(i)(2) (SSA §1848(i)(2))—Assistants-at-surgery.

Rate history by release Copy link

National Office (non-facility) amount for 88342 across quarterly releases. -4.4% decrease since Q1 2013 · peak $115.34 in Q1 2013

How often 88342 is billed Copy link

Across Original Medicare in CY2024, 88342 ranked #110 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 1.6 times on average that year.

2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q4 2014 fee schedule above.

Who bills 88342 to Medicare

Observed CY2024 Medicare fee-for-service billing, by the rendering clinician's CMS specialty. Each share is that specialty's slice of all observed services for this code that year.

Setting split that year: 39% Office (non-facility) · 61% facility. CMS publishes only this facility vs non-facility split, never the exact place of service. The Office (non-facility) figure does not identify urgent care or any other specific setting.

CY2024 Medicare fee-for-service only, from the CMS Physician & Other Practitioners dataset, which suppresses rows under 11 beneficiaries. We omit specialty groups with fewer than 30 observed clinicians, so the shares can fall short of 100%. Specialty and practice-type pages linked elsewhere on this page are curated code lists, not utilization claims.

Related codes Copy link

Codes near 88342 in the pathology and laboratory services group, with their national Q4 2014 amounts at GPCI 1.000. A dash means the release publishes no payable PFS amount in that setting.

Localis groups these codes for payment research. The grouping isn't the AMA's code families.