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See a sample rate comparisonCPT 88305 Fee Schedule
Last Verified: October 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 | Pathology and Laboratory Procedures Surgical Pathology Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $35.07 national non-facility rate (2026) · View Medicare rates for 88305 |
| Medicaid Fee Schedule | $62.305 median of the 8 states in the free preview · View Medicaid rates for 88305 |
National average reimbursement for CPT 88305 by major payers:
$80.65
$68.41
$97.17
$81.12
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CPT 88305
5 of 25 sample ratesHigher to lower in this preview
Katherine Weilbaecher
Washington University
$316.35Published rateHeather Bitar
City Of Hope Medical Foundation
$108.69Published rateMatthieu Mayer
$66.98Published rateKenneth Johnson
Marilyn S. Norton, M.D. And Kenneth B. Johnson, M.D.,
$36.70Published ratePrestige Dermatology Inc
$17.57Published rate
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See a sample payer proposalCPT 88305 vs. Other Surgical Pathology Procedures 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 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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Frequently Asked Questions
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.
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.
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.
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.
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.