Summary & Overview

CPT 3315F: Estrogen and Progesterone Receptor Status Assessment

CPT code 3315F represents documentation that a provider assessed estrogen or progesterone receptor (ER/PR) status in tumor cells for female patients aged 18 and older. Determining ER/PR positivity has national clinical importance because ER+/PR+ tumors often respond to endocrine therapies, influencing treatment selection and outcomes across oncology care. Payers commonly engage with this measure as part of quality reporting and coverage decisions for receptor-directed therapies. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code's clinical meaning, typical settings where the assessment occurs, and the role this documentation plays in care pathways for hormone receptor–positive tumors. The publication also outlines benchmarking context and policy considerations relevant to payers and provider billing operations. Where input data is incomplete, the report flags missing elements and indicates "Data not available in the input." The content is intended for national audiences involved in clinical operations, revenue cycle management, and payer policy who need a clear, practical summary of CPT code 3315F and its implications for oncology care documentation and quality measurement.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare3315FCPTPathologyOncologyER PR statusHormone receptorQuality measureLaboratory testing

Billing Code Overview

CPT code 3315F documents the provider's assessment of estrogen or progesterone receptor (ER/PR) status in tumor cells of female patients aged 18 years or older. The measure indicates whether tumor cells express ER or PR proteins, which predict responsiveness to therapies that interfere with estrogen production or utilization.

Service Type: Pathology/Oncology receptor status assessment

Typical Site of Service: Oncology clinic, pathology laboratory, or hospital outpatient setting

Clinical & Coding Specifications

Clinical Context

A typical patient is a female aged 18 years or older presenting with a breast mass or abnormal imaging (mammogram or ultrasound) suspicious for malignancy. Following core needle biopsy or surgical excision, tumor tissue is sent to pathology for histologic diagnosis and biomarker testing. The provider assesses tumor tissue for estrogen receptor (ER) and progesterone receptor (PR) status using immunohistochemistry (IHC). Results guide systemic therapy decisions: ER+ or PR+ tumors are likely to respond to endocrine therapies. The clinical workflow includes specimen collection in the operating room or radiology-guided biopsy suite, accessioning in the pathology lab, IHC staining and interpretation by a pathologist, documentation of percent staining and intensity, and incorporation of results into the pathology report for the treating medical oncologist and surgeon.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the professional interpretation/reporting of the pathology/IHC is billed separately from the technical component.
`TC`	Technical component	Use when only the laboratory technical service (processing/staining) is billed.
`59`	Distinct procedural service	Use when a separate, distinct procedure is performed on the same day that is not typically bundled with the pathology testing.
`76`	Repeat procedure by same physician	Use when repeat IHC testing is performed by the same provider during the same day.
`77`	Repeat procedure by another physician	Use when repeat IHC testing is performed by a different provider during the same day.
`90`	Reference (outside) laboratory	Use when the IHC testing is sent to an outside/referral laboratory and only the referring provider bills.
`91`	Repeat clinical diagnostic test	Use when repeat testing on the same specimen or patient is performed with immediate repeat results required.
`RT`	Right side	Use when laterality reporting is required and testing is specifically associated with a right-sided specimen (if applicable per payer rules).
`LT`	Left side	Use when laterality reporting is required and testing is specifically associated with a left-sided specimen (if applicable per payer rules).
`47`	Anesthesia by surgeon	Use if intraoperative specimen handling requires anesthesia services billed by the surgeon (rare; follow payer guidance).

Taxonomy Code	Specialty	Notes
`207RH0000X`	Anatomic Pathology	Pathologists who perform tissue diagnosis and interpret IHC.
`207RX0900X`	Hematopathology	Pathologists with expertise in tumor marker interpretation when hematologic malignancy overlap or complex testing is needed.
`207QS0016X`	Surgical Pathology	Pathologists focused on surgical specimens including breast excisions and core biopsies.
`208M00000X`	Medical Oncology	Medical oncologists order and utilize ER/PR results for systemic treatment planning.
`207L00000X`	Dermatopathology	Included only when skin or cutaneous breast pathology requires specialized interpretation (less common).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C50.911`	Malignant neoplasm of unspecified site of right female breast	ER/PR testing is standard for invasive breast cancer to guide systemic therapy when tumor is in the right breast.
`C50.912`	Malignant neoplasm of unspecified site of left female breast	ER/PR testing is standard for invasive breast cancer to guide systemic therapy when tumor is in the left breast.
`D05.90`	Unspecified type of carcinoma in situ of unspecified breast	ER/PR testing may be performed on ductal carcinoma in situ (DCIS) specimens in select cases.
`R92.8`	Other abnormal and inconclusive findings on diagnostic imaging of breast	Abnormal imaging leading to biopsy and receptor testing if malignancy is confirmed.
`N63`	Unspecified lump in breast	Core biopsy for a palpable mass frequently leads to ER/PR testing if malignancy is identified.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`88342`	Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain	Commonly performed for ER or PR IHC testing as the primary technical stain reported by pathology.
`88344`	Immunohistochemistry or immunocytochemistry, per specimen; each additional single antibody stain (List separately in addition to code for primary procedure)	Used when both ER and PR (two separate antibodies) or additional markers (eg, HER2) are stained on the same specimen.
`88341`	Immunohistochemistry or immunocytochemistry, per specimen; single antigen, per slide (technical component)	Represents technical staining component when billing professional and technical components separately.
`88360`	Morphometric analysis	Used when quantitative image analysis is performed to assess percentage of tumor cells staining for ER/PR.
`88172`	Cytopathology, cell block preparation	Used when cell block from fine needle aspiration is prepared and then subjected to IHC for receptor testing.
`88305`	Level IV surgical pathology, gross and microscopic examination	Used when a surgical excision specimen requires routine histopathologic evaluation in addition to IHC testing.