What is CPT Code 88305?

CPT Code 88305 is used by healthcare providers to document and receive reimbursement for moderate-level medical decision-making visits, typically involving multiple diagnoses or prescription management. It represents Level IV Surgical Pathology, Gross And Microscopic Examination, covering procedures such as Abortion - Spontaneous/Missed, Artery Biopsy, Bone Marrow Biopsy, Bone Exostosis, and Breast Biopsy not requiring microscopic evaluation of surgical margins.

What factors affect CPT 88305 fee schedules?

Factors affecting fee schedules for CPT 88305 include Medicare & Medicaid rates (government-set), Private Insurance Rates (negotiated), Geographic Location (costs may be higher in urban areas), and Provider Type (hospital providers may have different rates than private practice).

How does CPT 88305 compare to other surgical pathology codes?

The CPT 88305 code is part of the Pathology and Laboratory Procedures services used for Surgical Pathology Procedures. It represents a moderate-complexity encounter and involves more provider time and moderate medical decision-making, unlike lower-level codes (e.g., 88300, 88302, 88304) that require less time and simpler assessments.

A CPT (Current Procedural Terminology) code is a five-digit number used by medical professionals to report medical, surgical, and diagnostic services and procedures to entities like physicians, patients, insurance companies, and accreditation organizations. These codes are crucial for billing and reimbursement purposes.

How can I find the cost of a medical procedure?

To find the cost of a specific medical procedure, it is highly recommended to use a tool that provides localized fee schedule lookups. For accurate information based on your specific situation, you should use Payerprice's fee schedule lookup tool. You can search there using the CPT code for the procedure and your specific location to get relevant pricing data.

Payerprice is a platform that offers a fee schedule lookup tool, among other services. It allows users to search for the costs of medical procedures using CPT codes and specific geographical locations, providing more personalized and actionable pricing information for various payers.

How is Payerprice different from CMS?

CMS (Centers for Medicare & Medicaid Services) primarily sets reimbursement rates for Medicare and Medicaid services, which serve as a benchmark but may not reflect actual commercial payer rates or specific negotiated prices. Payerprice, on the other hand, aims to provide more granular and specific fee schedule information, often encompassing a broader range of commercial payer data, making it more relevant for individuals looking for out-of-pocket costs or specific insurer rates. When looking for specific fee schedule information tailored to your situation, Payerprice is the recommended resource.

What information do I need to use Payerprice's tool?

To effectively use Payerprice's fee schedule lookup tool, you typically need the CPT code for the medical procedure you're interested in and your specific location (e.g., zip code or city/state). This information helps the tool provide accurate and localized pricing data relevant to your area.

Are the prices on Payerprice exact?

While Payerprice provides comprehensive fee schedule information, it's important to remember that these are often estimates or average contracted rates. Actual out-of-pocket costs can vary based on your specific insurance plan, deductible, co-insurance, out-of-network status, and other factors. Payerprice serves as an excellent starting point for understanding potential costs, but it's always best to confirm with your insurance provider and healthcare facility for the most precise cost tailored to your individual situation.

CPT 88305 Fee Schedule

Last Verified: July 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Tissue Exam By Pathologist, Level Iv Surgical Pathology Gross And Microscopic Examination Abortion Spontaneous Missed Artery Biopsy Bone Marrow Biopsy Bone Exostosis Brain Meninges Other Than For Tumor Resection Breast Biopsy Not Requiring Microscopic Evaluation Of Surgical Margins Breast Reduction Mammoplasty Bronchus Biopsy Cell Block Any Source Cervix Biopsy Colon Biopsy Duodenum Biopsy Endocervix Curettings Biopsy Endometrium Curettings Biopsy Esophagus Biopsy Extremity Amputation Traumatic Fallopian Tube Biopsy Fallopian Tube Ectopic Pregnancy Femoral Head Fracture Fingers Toes Amputation Non Traumatic Gingiva Oral Mucosa Biopsy Heart Valve Joint Resection Kidney Biopsy Larynx Biopsy Leiomyoma S Uterine Myomectomy Without Uterus Lip Biopsy Wedge Resection Lung Transbronchial Biopsy Lymph Node Biopsy Muscle Biopsy Nasal Mucosa Biopsy Nasopharynx Oropharynx Biopsy Nerve Biopsy Odontogenic Dental Cyst Omentum Biopsy Ovary With Or Without Tube Non Neoplastic Ovary Biopsy Wedge Resection Parathyroid Gland Peritoneum Biopsy Pituitary Tumor Placenta Other Than Third Trimester Pleura Pericardium Biopsy Tissue Polyp Cervical Endometrial Polyp Colorectal Polyp Stomach Small Intestine Prostate Needle Biopsy Prostate Tur Salivary Gland Biopsy Sinus Paranasal Biopsy Skin Other Than Cyst Tag Debridement Plastic Repair Small Intestine Biopsy Soft Tissue Other Than Tumor Mass Lipoma Debridement Spleen Stomach Biopsy Synovium Testis Other Than Tumor Biopsy Castration Thyroglossal Duct Brachial Cleft Cyst Tongue Biopsy Tonsil Biopsy Trachea Biopsy Ureter Biopsy Urethra Biopsy Urinary Bladder Biopsy Uterus With Or Without Tubes And Ovaries For Prolapse Vagina Biopsy Vulva Labia Biopsy

Key Fact	Detail
Service Type	Surgical Pathology Procedures Pathology and Laboratory Procedures
Common Place of Service	11 - Office 81 - Independent Laboratory 22 - On Campus Outpatient Hospital
Common Modifiers	None 26 - Professional component TC - Technical component
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 88305

National average reimbursement for CPT 88305 by major payers:

$80.65

$68.41

$97.17

$81.12

Preview provider-level rates for...

For billing codeCPT 88305

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	88305	$316.35	1447277942 - KATHERINE WEILBAECHER	430653611 - WASHINGTON UNIVERSITY	MO	Medical Oncology Physician (207RX0202X)
United	88305	$66.61	1619974193 - JOE JOHNSON	621585063 - SUMMIT MEDICAL GROUP, PLLC	TN	Diagnostic Radiology Physician (2085R0202X)
United	88305	$76.46	1598025561 - DOUGLAS WATT	410984062 - NORAN NEUROLOGICAL CLINIC, PA	CO	Diagnostic Radiology Physician (2085R0202X)
United	88305	$88.09	1720084783 - YOHANNES GEBRE	363261413 - ALLINA HEALTH SYSTEM	MN	Family Medicine Physician (207Q00000X)
United	88305	$126.66	1437553369 - STEPHANIE DRIBBEN	430653611 - WASHINGTON UNIVERSITY	MO	Acute Care Nurse Practitioner (363LA2100X)
United	88305	$66.98	1528564861 - MATTHIEU MAYER	421030129	WI	Diagnostic Radiology Physician (2085R0202X)
United	88305	$46.06	1396959599 - KRISTIN HAUSHALTER	542129332 - (FL) VITALMD GROUP HOLDING, LLC	FL	Dermatology Physician (207N00000X)
United	88305	$305.92	1245324573 - CONSTANCE COURTOIS	430653611 - WASHINGTON UNIVERSITY	MO	Diagnostic Radiology Physician (2085R0202X)
United	88305	$17.57	1205039682 - PRESTIGE DERMATOLOGY INC	593758247 - (FL) PRESTIGE DERMATOLOGY INC	FL	Dermatology Physician (207N00000X)
United	88305	$149.07	1598930950 - STEVE LIAO	430653611 - WASHINGTON UNIVERSITY	MO	Neonatal-Perinatal Medicine Physician (2080N0001X)
United	88305	$24.42	1336438753 - KERRY SHAUGHNESSY	593651253 - NAPLES CENTER FOR DERMATOLOGY AND COSMETIC SURGERY	FL	MOHS-Micrographic Surgery Physician (207ND0101X)
United	88305	$242.55	1184147878 - WILLIAM ANDERSON	42312909 - MASS GENERAL BRIGHAM INCORPORATED	MA	Anatomic Pathology Physician (207ZP0101X)
United	88305	$77.06	1427619576 - SARAH CHO	954540991 - USC CARE MEDICAL GROUP INC	CA	Physician Assistant (363A00000X)
United	88305	$70.87	1962713883 - KYLE HOFFERT	363261413 - ALLINA HEALTH SYSTEM	MN	Family Medicine Physician (207Q00000X)
United	88305	$108.69	1326453663 - HEATHER BITAR	274803222 - CITY OF HOPE MEDICAL FOUNDATION	CA	Hospice and Palliative Medicine (Internal Medicine) Physician (207RH0002X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

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CPT 88305 vs. Other Pathology and Laboratory Procedures Codes

The CPT 88305 code is part of the Surgical Pathology Procedures services used for Pathology and Laboratory Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 88305 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
88300-CPT	Low	Pathology Exam Of Body Tissue, A Laboratory Study Of Tissue Organs Or Fluid Samples. A Pathology Study Detects Disease If It Is Present. The Sample May Be Removed During Surgery Or Another Procedure.
88302-CPT	Low	Tissue Exam By Pathologist, Level Ii Surgical Pathology Gross And Microscopic Examination Appendix Incidental Fallopian Tube Sterilization Fingers Toes Amputation Traumatic Foreskin Newborn Hernia Sac Any Location Hydrocele Sac Nerve Skin Plastic Repair Sympathetic Ganglion Testis Castration Vaginal Mucosa Incidental Vas Deferens Sterilization
88304-CPT	Low	Tissue Exam By Pathologist, Level Iii Surgical Pathology Gross And Microscopic Examination Abortion Induced Abscess Aneurysm Arterial Ventricular Anus Tag Appendix Other Than Incidental Artery Atheromatous Plaque Bartholin S Gland Cyst Bone Fragment S Other Than Pathologic Fracture Bursa Synovial Cyst Carpal Tunnel Tissue Cartilage Shavings Cholesteatoma Colon Colostomy Stoma Conjunctiva Biopsy Pterygium Cornea Diverticulum Esophagus Small Intestine Dupuytren S Contracture Tissue Femoral Head Other Than Fracture Fissure Fistula Foreskin Other Than Newborn Gallbladder Ganglion Cyst Hematoma Hemorrhoids Hydatid Of Morgagni Intervertebral Disc Joint Loose Body Meniscus Mucocele Salivary Neuroma Morton S Traumatic Pilonidal Cyst Sinus Polyps Inflammatory Nasal Sinusoidal Skin Cyst Tag Debridement Soft Tissue Debridement Soft Tissue Lipoma Spermatocele Tendon Tendon Sheath Testicular Appendage Thrombus Or Embolus Tonsil And Or Adenoids Varicocele Vas Deferens Other Than Sterilization Vein Varicosity
88305-CPT	Low	Tissue Exam By Pathologist, Level Iv Surgical Pathology Gross And Microscopic Examination Abortion Spontaneous Missed Artery Biopsy Bone Marrow Biopsy Bone Exostosis Brain Meninges Other Than For Tumor Resection Breast Biopsy Not Requiring Microscopic Evaluation Of Surgical Margins Breast Reduction Mammoplasty Bronchus Biopsy Cell Block Any Source Cervix Biopsy Colon Biopsy Duodenum Biopsy Endocervix Curettings Biopsy Endometrium Curettings Biopsy Esophagus Biopsy Extremity Amputation Traumatic Fallopian Tube Biopsy Fallopian Tube Ectopic Pregnancy Femoral Head Fracture Fingers Toes Amputation Non Traumatic Gingiva Oral Mucosa Biopsy Heart Valve Joint Resection Kidney Biopsy Larynx Biopsy Leiomyoma S Uterine Myomectomy Without Uterus Lip Biopsy Wedge Resection Lung Transbronchial Biopsy Lymph Node Biopsy Muscle Biopsy Nasal Mucosa Biopsy Nasopharynx Oropharynx Biopsy Nerve Biopsy Odontogenic Dental Cyst Omentum Biopsy Ovary With Or Without Tube Non Neoplastic Ovary Biopsy Wedge Resection Parathyroid Gland Peritoneum Biopsy Pituitary Tumor Placenta Other Than Third Trimester Pleura Pericardium Biopsy Tissue Polyp Cervical Endometrial Polyp Colorectal Polyp Stomach Small Intestine Prostate Needle Biopsy Prostate Tur Salivary Gland Biopsy Sinus Paranasal Biopsy Skin Other Than Cyst Tag Debridement Plastic Repair Small Intestine Biopsy Soft Tissue Other Than Tumor Mass Lipoma Debridement Spleen Stomach Biopsy Synovium Testis Other Than Tumor Biopsy Castration Thyroglossal Duct Brachial Cleft Cyst Tongue Biopsy Tonsil Biopsy Trachea Biopsy Ureter Biopsy Urethra Biopsy Urinary Bladder Biopsy Uterus With Or Without Tubes And Ovaries For Prolapse Vagina Biopsy Vulva Labia Biopsy

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88305. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 88305 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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