CPT code 88304: Tissue pathology exam, level III specimen2026 Medicare rate & RVUs

Medicare pays $41.08 for 88304 nationally in the office. Local office rates run $36.05–$56.31.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 88304 covers

Code 88304 covers gross and microscopic examination of a surgical specimen assigned to Level III in CPT's surgical pathology specimen list. Common examples include gallbladders removed at cholecystectomy, hemorrhoids, tonsils and adenoids, lipomas, skin cysts, intervertebral disc material, and varicose veins. Laboratory staff gross, process, section, and routinely stain the tissue; a pathologist examines the slides and issues a diagnosis. This work occurs in hospital laboratories, independent laboratories, and pathology group practices.

Report one unit for each distinct specimen examined, not automatically for each container or tissue fragment. Select the listed specimen level rather than grading complexity or time; for an unlisted specimen, compare the physician work with listed specimens. Document each specimen's source, gross and microscopic findings, and diagnosis. Modifier 26 identifies the professional component, including interpretation; modifier TC identifies the technical component, including preparation, equipment, and staff. Report the code without either modifier when billing for both components. Separately performed, medically necessary decalcification, special stains, or immunohistochemistry may be reported with the appropriate additional codes.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 88304 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

88304 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 88304 rate is calculated

Each of 88304’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 88304

The CMS indicators that decide how 88304 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

88304 compared with similar codes

How to choose

88305Tissue pathology examLevel IV specimen

88305 covers Level IV specimens, including common skin, colon, and stomach biopsies. 88304 covers Level III specimens such as gallbladders, hemorrhoids, tonsils, and lipomas; select by the CPT specimen list.

88302Tissue pathologyLevel II specimen

88302 covers Level II specimens such as an incidental appendix, sterilization fallopian tubes or vas deferens, and hernia sacs. 88304 covers specimens assigned to Level III.

88300Gross pathologyGross examination only

88300 covers gross examination only, without microscopic review, for items such as foreign bodies. 88304 includes both gross and microscopic examination of a Level III specimen.

Codes related to 88304

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates