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See a sample rate comparisonCPT 88321 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 Pathology Consultation, Consultation Requested By The Primary Physician For An Opinion Or Advice About The Results Of A Study Of Diseased Or Atypical Tissue Sample.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Surgical Pathology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | GC - Service performed by resident under supervision 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $93.86 national non-facility rate (2026) · View Medicare rates for 88321 |
| Medicaid Fee Schedule | $77.94 median of the 8 states in the free preview · View Medicaid rates for 88321 |
National average reimbursement for CPT 88321 by major payers:
$109.81
$80.61
$151.02
$88.37
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CPT 88321
5 of 25 sample ratesHigher to lower in this preview
J Rubin
City Of Hope Medical Foundation
$346.85Published rateAlyse Schiarelli
Association Of University Physicians
$207.30Published rateDuncan Hussey
Association Of University Physicians
$207.30Published rateStephanie Binick
Association Of University Physicians
$200.13Published rateThe Oncology Institute Fl, LLC, The Oncology Institute Of Hope And Innovation
Agajanian Institute Of Oncology And Hematology
$63.70Published rate
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See a sample payer proposalCPT 88321 vs. Other Surgical Pathology Procedures Codes
The CPT 88321 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 88321 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 |
|---|---|---|
| 88321-CPT | Low | Tissue Pathology Consultation, Consultation Requested By The Primary Physician For An Opinion Or Advice About The Results Of A Study Of Diseased Or Atypical Tissue Sample. |
| 88323-CPT | Low | Tissue Pathology Consultation, Consultation Requested By The Primary Physician For An Opinion Or Advice About The Results Of A Study Of Diseased Or Atypical Tissue Sample. |
| 88325-CPT | Low | Tissue Pathology Consultation, Consultation Requested By The Primary Physician For An Opinion Or Advice About The Results Of A Study Of Diseased Or Atypical Tissue Sample. |
| 88329-CPT | Low | Surgical Pathology Consult, A Consultation During Surgery Involving A Simple Visual Or Physical Exam Of The Tissue In Question. The Operating Physician Requests An Opinion Or Advice From Another Physician In Order To Make An Immediate Decision On How To Proceed With The Surgery. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88321. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88321 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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