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See a sample rate comparisonCPT 88323 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 | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $112.90 national non-facility rate (2026) · View Medicare rates for 88323 |
| Medicaid Fee Schedule | $100.46 median of the 8 states in the free preview · View Medicaid rates for 88323 |
National average reimbursement for CPT 88323 by major payers:
$135.99
$104.74
$138.75
$126.62
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CPT 88323
5 of 25 sample ratesHigher to lower in this preview
Tawee Tanvetyanon
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$144.19Published rateNicholas Figura
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$112.41Published rateAndrew Delgaizo
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$31.78Published rateGarrett Lund
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$27.01Published rateEvadne Edwards
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$27.00Published rate
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See a sample payer proposalCPT 88323 vs. Other Surgical Pathology Procedures Codes
The CPT 88323 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 88323 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 88323. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88323 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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