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See a sample rate comparisonCPT 88319 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.
Identify Enzyme In Tissue, The Test Involves Staining A Tissue Sample. If A Suspected Enzyme Is Present It Will Turn A Color Different From The Surrounding Tissue.
| 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 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $131.93 national non-facility rate (2026) · View Medicare rates for 88319 |
| Medicaid Fee Schedule | $109.90 median of the 8 states in the free preview · View Medicaid rates for 88319 |
National average reimbursement for CPT 88319 by major payers:
$151.55
$97.26
$138.14
$135.14
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CPT 88319
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
St Francis Hospital
$195.31Published rateChristopher Raio
St Francis Hospital
$104.27Published rateAll Ways Homecare Inc
$55.00Published rateChristopher Raio
St Joseph Hospital
$40.65Published rateChristopher Raio
St Joseph Hospital
$18.82Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 88319 vs. Other Surgical Pathology Procedures Codes
The CPT 88319 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 88319 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 |
|---|---|---|
| 88285-CPT | Low | Additional Cell Count In Study, Additional Cells Counted Beyond The Base Chromosome Analysis. The Study Uses Traditional Microscopic Techniques To Check For Genetic Anomalies And Recessive Traits. Additional Cell Counts May Be Necessary To Pinpoint A Diagnosis For Certain Cancers. |
| 88289-CPT | Low | Study For Inherited Condition, The Study Analyzes Chromosomes To Find Out If They Contain Any Genetic Traits Associated With Inherited Conditions. The Study Involves Several High-Resolution Examinations. |
| 88291-CPT | Low | Cytogentic & Molecular Cytogentic Interpret & Rport, Cytogenetics And Molecular Cytogenetics Interpretation And Report |
| 88319-CPT | Low | Identify Enzyme In Tissue, The Test Involves Staining A Tissue Sample. If A Suspected Enzyme Is Present It Will Turn A Color Different From The Surrounding Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88319. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88319 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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