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See a sample rate comparisonCPT 88311 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.
Decalcification Proc (List Sepa In Addition To Code For Sur, Decalcification Procedure (List Separately In Addition To Code For Sur
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Surgical Pathology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $19.71 national non-facility rate (2026) · View Medicare rates for 88311 |
| Medicaid Fee Schedule | $16.305 median of the 8 states in the free preview · View Medicaid rates for 88311 |
National average reimbursement for CPT 88311 by major payers:
$23.69
$17.45
$24.00
$21.28
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CPT 88311
5 of 25 sample ratesHigher to lower in this preview
Christine Chung
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$27.03Published rateBryn Barna
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$22.96Published rateSaraswathi Cappelle
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$16.14Published rateMark Ledbetter
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$10.88Published rateKelsey Logan
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$9.22Published rate
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See a sample payer proposalCPT 88311 vs. Other Surgical Pathology Procedures Codes
The CPT 88311 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 88311 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 |
|---|---|---|
| 88311-CPT | Low | Decalcification Proc (List Sepa In Addition To Code For Sur, Decalcification Procedure (List Separately In Addition To Code For Sur |
| 88312-CPT | Low | Special Stains (List Separatel, Special Stains (List Separately In Addition To Code Forsurgical Pathology Examination) Group I For Microorganisms (Eg Gridley Acid Fast Methenamine Silver) Each |
| 88313-CPT | Low | Special Stains Group 2, Special Stain Including Interpretation And Report Group Ii All Other Eg Iron Trichrome Except Stain For Microorganisms Stains For Enzyme Constituents Or Immunocytochemistry And Immunohistochemistry |
| 88314-CPT | Low | Special Stains Histochemical, Special Stains Histochemical Staining With Frozensection(S) Including Interpretation And Report ( List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88311. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88311 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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