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See a sample rate comparisonCPT 88313 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 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
| 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 | $80.83 national non-facility rate (2026) · View Medicare rates for 88313 |
| Medicaid Fee Schedule | $66.995 median of the 8 states in the free preview · View Medicaid rates for 88313 |
National average reimbursement for CPT 88313 by major payers:
$87.71
$60.51
$91.39
$81.45
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CPT 88313
5 of 25 sample ratesHigher to lower in this preview
Katrina Bassel
$148.27Published rateSahibzada Shah
Yuma Regional Medical Center
$69.44Published rateJay Takata
$46.34Published rateAmit Mori
$12.34Published rateJessica Bernica
Texas Childrens Physician Group
$6.82Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 88313 vs. Other Surgical Pathology Procedures Codes
The CPT 88313 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 88313 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 88313. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88313 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 accurate pricing for a specific medical procedure or service, it's best to use a specialized tool. Payerprice offers a fee schedule lookup tool where you can search by CPT code and specific location to find relevant cost information for your situation.
For detailed fee schedule information linked to CPT codes, you should use a dedicated lookup service. Payerprice provides a comprehensive fee schedule lookup tool, allowing you to search with a CPT code and your specific location to get an understanding of expected costs.
Yes, comparing healthcare service prices by location is crucial for informed decision-making. Payerprice offers a fee schedule lookup tool that allows you to input a CPT code and a specific location to view and compare pricing, helping you understand the cost variations in different areas.
To effectively use Payerprice's fee schedule lookup tool, you will typically need the CPT (Current Procedural Terminology) code for the medical service you are interested in, and the specific geographic location (e.g., zip code or city/state) where you plan to receive the service. This information allows Payerprice to provide you with relevant cost estimates.