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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 | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $187.71 national non-facility rate (2026) · View Medicare rates for 88381 |
| Medicaid Fee Schedule | $176.25 median of the 8 states in the free preview · View Medicaid rates for 88381 |
National average reimbursement for CPT 88381 by major payers:

$213.80

$153.64

$192.60

$212.24
Choose a payer to see a sample of rates for CPT 88381.
Ahmad Arslan
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
Rutvi Trivedi
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
Daquanda Arnett
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
Kendra Sweet
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
Jaden Shapiro
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
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Rate Benchmarking
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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 88381 vs. Other Surgical Pathology Procedures Codes
The CPT 88381 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 88381 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 |
|---|---|---|
| 88375-CPT | Low | Examination With Scope, An Examination Using An Endoscope That Has A Microscope Attached For Taking Cellular Level Images (Endomicroscope). An Interpretation Of The Images And A Report Are Included. |
| 88377-CPT | Moderate | 3-D Genetic Analysis Of Tissue, Genetic Material From A Tissue Sample Is Studied Using Morphometric Analysis A Technique For Learning About The Cause And Progression Of A Disease. |
| 88380-CPT | Low | Microscopic Tissue Sampling, Individual Cells Are Removed From An Area Of Tissue To Examine How A Disease Is Progressing. Multiple Samples May Be Removed. The Samples May Be Taken Manually Or With The Aid Of A Laser. |
| 88381-CPT | Moderate | Microscopic Tissue Sampling, Individual Cells Are Removed From An Area Of Tissue To Examine How A Disease Is Progressing. Multiple Samples May Be Removed. The Samples May Be Taken Manually Or With The Aid Of A Laser. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 88381. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 88381 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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