Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHealthcare 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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Surgical Pathology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | 59 - Distinct Procedural Service TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $22.71 national non-facility rate (2026) · View Medicare rates for 88363 |
| Medicaid Fee Schedule | $18.635 median of the 8 states in the free preview · View Medicaid rates for 88363 |
National average reimbursement for CPT 88363 by major payers:

$29.87

$24.90

$39.45

$52.30
Choose a payer to see a sample of rates for CPT 88363.
Bradley Weisner
Urology Specialists Of The Carolinas, PLLC
Baycare Home Care, Inc.
Baycare Home Care Inc
Nevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
Christopher Raio
St Francis Hospital
Christopher Raio
Samaritan Emergency Medical Services PC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 88363 vs. Other Surgical Pathology Procedures Codes
The CPT 88363 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 88363 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 |
|---|---|---|
| 88362-CPT | Moderate | Nerve Teasing Preparations |
| 88363-CPT | Low | Examination And Selection Of R, Examination And Selection Of Retrieved Archival (Ie Previously Diagnosed) Tissue(S) For Molecular Analysis (Eg Kras Mutational Analysis) |
| 88364-CPT | Low | In Situ Hybridization (Eg Fis, In Situ Hybridization (Eg Fish) Per Specimen Each Additional Single Probe Stain Procedure (List Separately In Addition To Code For Primary Procedure) |
| 88365-CPT | Low | Study Of Genetic Risk Factor, The Study Identifies Genetic Abnormalities In Tissues That Can Be Linked With Cancers Or Other Changes In The Body. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88363. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88363 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.
Bring your top codes (like CPT 88363) and we'll show you how you compare in 15 minutes or less.