Cost analysis for CPT 88120 — Cell examination of urine, manual
Average Medicare Payment
$281.61
2023 data
Total Payments (2023)
$22.1M
Services (2023)
59.5K
Price Change (2014–2023)
+3.8%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $271.32 | $38.9M | 98.6K | — |
| 2015 | $272.60 | $36.8M | 91.0K | +0.5% |
| 2016 | $283.51 | $37.3M | 88.0K | +4.0% |
| 2017 | $282.81 | $30.7M | 73.8K | -0.2% |
| 2018 | $310.35 | $29.0M | 67.9K | +9.7% |
| 2019 | $305.90 | $25.4M | 63.3K | -1.4% |
| 2020 | $294.47 | $20.5M | 51.6K | -3.7% |
| 2021 | $304.10 | $24.4M | 55.9K | +3.3% |
| 2022 | $309.18 | $23.2M | 58.8K | +1.7% |
| 2023 | $281.61 | $22.1M | 59.5K | -8.9% |
The most expensive state pays 5.8x more than the cheapest for this procedure. DC averages $479.47 vs DE at $82.26.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| DC | $479.47 | $444.5K | 927 | 3 |
| MD | $454.98 | $642.9K | 1.4K | 10 |
| NY | $446.04 | $4.1M | 9.3K | 31 |
| IL | $424.37 | $778.3K | 1.8K | 7 |
| MI | $421.85 | $98.3K | 233 | 4 |
| TN | $418.69 | $1.0M | 2.4K | 7 |
| TX | $417.90 | $1.8M | 4.3K | 15 |
| CA | $396.73 | $2.1M | 5.3K | 17 |
| CT | $374.17 | $860.2K | 2.3K | 5 |
| MO | $373.46 | $143.0K | 383 | 5 |
| FL | $354.60 | $1.3M | 3.7K | 17 |
| NJ | $352.00 | $5.0M | 14.2K | 18 |
| VA | $351.63 | $307.3K | 874 | 6 |
| OK | $345.31 | $668.9K | 1.9K | 1 |
| MA | $325.15 | $1.6M | 5.0K | 28 |
| MN | $303.80 | $47.7K | 157 | 5 |
| AZ | $302.84 | $590.8K | 2.0K | 16 |
| KS | $225.09 | $26.3K | 117 | 1 |
| PA | $164.17 | $357.4K | 2.2K | 9 |
| OH | $97.25 | $40.6K | 417 | 12 |
| DE | $82.26 | $13.3K | 162 | 4 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Bader Pedemonte | Pathology | NJ | $2.4M | 8.8K | $275.19 |
| Michael Nagar | Pathology | NY | $2.3M | 4.0K | $579.54 |
| Emeritus Medical Technology Llc | Clinical Laboratory | CA | $1.2M | 2.3K | $505.90 |
| Raul Rudelli | Pathology | NJ | $905.8K | 1.6K | $580.62 |
| Nicholas Maruniak | Pathology | FL | $877.3K | 1.9K | $453.63 |
| Eastgene Laboratories Inc | Clinical Laboratory | NY | $815.6K | 1.6K | $519.81 |
| Dianon Systems, Inc | Clinical Laboratory | CT | $814.0K | 2.0K | $401.20 |
| Dianon Systems Inc | Clinical Laboratory | OK | $668.9K | 1.9K | $345.31 |
| Neogenomics Laboratories Inc | Clinical Laboratory | TX | $610.7K | 1.4K | $433.41 |
| Michael Brancaccio | Pathology | DC | $441.5K | 866 | $509.82 |
| Convergent Diagnostics, Llc | Clinical Laboratory | TX | $425.9K | 958 | $444.53 |
| Mona Sharaan | Pathology | NJ | $408.4K | 706 | $578.46 |
| David Hull | Pathology | TX | $406.8K | 902 | $450.98 |
| Quest Diagnostics Nichols Institute | Clinical Laboratory | CA | $392.7K | 784 | $500.88 |
| Petronela Iorga | Pathology | MA | $343.2K | 1.2K | $282.93 |
| Richard Roberts | Pathology | TN | $330.2K | 794 | $415.91 |
| Changhyun Choi | Pathology | TN | $326.4K | 787 | $414.79 |
| Amjad Khan | Pathology | NJ | $286.7K | 583 | $491.80 |
| Lincoln Diagnostics Llc | Clinical Laboratory | NJ | $284.4K | 543 | $523.77 |
| Jim Lu | Pathology | IL | $273.7K | 584 | $468.62 |
The data suggests significant pricing inconsistencies for CPT 88120. With a 5.8x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.