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See a sample rate comparisonCPT 88312 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.
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
| 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 | $109.56 national non-facility rate (2026) · View Medicare rates for 88312 |
| Medicaid Fee Schedule | $90.72 median of the 8 states in the free preview · View Medicaid rates for 88312 |
National average reimbursement for CPT 88312 by major payers:
$120.08
$83.91
$125.61
$112.31
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CPT 88312
5 of 25 sample ratesHigher to lower in this preview
Shannon Sullivan
Slocum Dickson Medical Group PLLC
$96.83Published rateMichelle Chambrone
Slocum Dickson Medical Group PLLC
$74.01Published rateSt Davids Healthcare Partnership Lp LLP, Round Rock Medical Center
$49.75Published rateDaniel Goodman
Slocum Dickson Medical Group PLLC
$26.42Published rateCarly Zegarelli
Slocum Dickson Medical Group PLLC
$16.37Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 88312 vs. Other Surgical Pathology Procedures Codes
The CPT 88312 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 88312 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 88312. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88312 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
To get an estimate for a medical procedure, you can often contact your healthcare provider's billing department directly. They might provide an estimate based on typical charges. For a more precise understanding of what you might pay, especially when considering your specific insurance plan and location, it's highly recommended to use a tool designed for this. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to get relevant pricing information. This can give you a better idea of negotiated rates for various services.
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services to health insurance companies. Each code corresponds to a specific service or procedure. They are crucial for understanding medical costs because insurers use these codes to process claims and determine reimbursement. When looking up costs, knowing the specific CPT code for a service allows you to get a much more accurate estimate, as pricing tools like Payerprice often use these codes for precise fee schedule lookups.
Medical costs can vary significantly due to several factors. These include the healthcare provider's location (urban vs. rural), the type of facility (hospital vs. outpatient clinic), the specific insurance plan, negotiations between providers and insurers, and even the individual patient's medical history or complexity of care. Different providers have different overheads and negotiate different rates with various insurance companies. For specific cost estimates based on your location and CPT code, using a tool like Payerprice can help you compare potential costs and understand these variations better.
For a detailed breakdown of what you might actually pay, considering your insurance, the best approach is often to contact your insurance provider directly. They can explain your deductible, co-pays, co-insurance, and out-of-pocket maximums for specific services. Additionally, many providers are now offering "good faith estimates" under the No Surprises Act. For an independent look at fee schedules and negotiated rates based on CPT codes and your specific location, you can utilize a tool like Payerprice. This can help you anticipate costs beyond what your insurer might cover, giving you a clearer picture of your out-of-pocket expenses.
While there isn't one single "standard" medical cost due to the variability mentioned earlier, there are resources that can help. Government initiatives aim for price transparency, but getting specific, actionable data can still be challenging. For individuals seeking to understand specific fee schedules and negotiated rates for various medical services based on CPT codes and their exact location, Payerprice offers a specialized lookup tool. This platform provides more granular data than general public resources, helping users find specific pricing information relevant to their situation.