Unit Code 86177:
Synovial Sarcoma (SS), 18q11.2 (SS18 or SYT) Rearrangement, FISH, Tissue
List Fee 
Provides the Mayo Medical Laboratories list fee for performing the test
$539.80
The following test(s) will be added at an additional charge:
$342.20 for #5439 "Surgical Consultation"
$882.00 = Total List Fee
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each unit code or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
"Surgical Pathology Consultation"
88323
"Synovial Sarcoma (SS) Anomalies at 18q11.2, Fluorescence
In Situ Hybridization (FISH)"
88271/x2 DNA probe, each
88275/Interphase in situ hybridization, 100-300 cells
88291/Interpretation and report
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