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CPT 88360: Single-Antibody Immunohistochemistry With Pathologist Interpretation
CPT code 88360 denotes a single-antibody immunohistochemistry (IHC) stain performed on slide(s) from a single patient specimen with direct pathologist evaluation and interpretation, including manual counting or estimation of positive cells. This code is widely used in diagnostic pathology for tumor characterization and biomarker assessment, making it clinically significant for oncology workflows and treatment planning across the U.S.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of CPT code 88360, its clinical role in immunohistochemistry, and how it relates to adjacent pathology codes for additional stains or quantitative analysis. The publication outlines typical sites of service and service type to aid billing and clinical teams in accurate claim categorization.
This summary provides national-level context rather than jurisdiction-specific guidance. The full document covers common modifiers and related codes for sequencing additional stains, comparative coding definitions (including related CPT pathology codes), and diagnostic contexts where 88360 is commonly applied, such as breast tumor receptor evaluation. The focus is on clear coding definition, clinical relevance, and operational context for pathology and laboratory stakeholders.
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Billing Code Overview
CPT code 88360 describes a pathology service in which a laboratory analyst applies a single antibody stain to slide(s) prepared from a single patient specimen, commonly tumor tissue. A qualified provider, typically a pathologist, evaluates the stained slide(s), including manual counting or estimating of stained cells, and interprets the findings to render a pathologic diagnosis.
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Service type: Immunohistochemistry / single-antibody stain with pathologist interpretation
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Typical site of service: Hospital pathology laboratory, independent clinical laboratory, or outpatient hospital/ambulatory surgical center laboratory
National Reimbursement Benchmarks
Across national payers, Medicare's mean rate of $83.6 sits modestly below BUCA's average commercial mean of $118.00 for CPT 88360, indicating commercial BUCA payments are roughly $34.40 higher than Medicare on average. This gap highlights a typical commercial premium versus Medicare but still places BUCA near the mid-range of commercial payers overall.
Dispersion measured by the interquartile range (P75–P25) varies notably: Aetna has the widest spread at $110.00 ($174.20 - $60.20), followed by Blue Cross Blue Shield at $62.30 and Cigna at $78.40. UnitedHealth Group's spread is $59.70. BUCA's spread is $68.10, while Medicare's IQR is $75.00. Aetna is the most variable and UnitedHealth Group the tightest among those with full quartile data.