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

Report 88304 for a pathologist's gross and microscopic examination of a Level III surgical specimen, such as a gallbladder, hemorrhoid, or tonsil.

CMS RVU26DEffective Oct 1, 2026One payment locality796.5K Medicare services in 2024

In New Mexico, Medicare pays $38.45 for 88304 in the office.

$38.45Office (non-facility)
Not available in this settingHospital or facility
−6.4%vs the national office rate ($41.08)

Check a contract rate as a % of Medicare · 88304 nationwide

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

We’ll open 88304 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 88304 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How New Mexico compares for 88304

Across 109 of 109 payment localities, the office rate for 88304 runs from $36.05 in Arkansas to $56.31 in San Benito County, CA. New Mexico pays $38.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

88304 in New Mexico vs other payment areas
  1. New Mexico · this page$38.45
  2. Los Angeles, CA · California$47.26+$8.81
  3. Washington, DC area · District of Columbia$47.48+$9.03
  4. Miami, FL · Florida$43.47+$5.02
  5. Chicago, IL · Illinois$42.16+$3.71
  6. Manhattan, NY · New York$47.33+$8.88
  7. Alaska · Alaska$46.46+$8.01

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

88304 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$36.62—
ArkansasArkansas$36.05—
ArizonaArizona$39.95—
Bakersfield, CACalifornia$44.16—
Chico, CACalifornia$44.10—
El Centro, CACalifornia$44.10—
Fresno, CACalifornia$44.10—
Hanford, CACalifornia$44.10—

88304 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$36.05

$50.21

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
88304 office rate range by state
State / territoryOffice rate rangeLocalities
AK$46.461
AL$36.621
AR$36.051
AZ$39.951
CA$44.10–$56.3129
CO$43.161
CT$43.941
DC$47.481
DE$40.651
FL$39.95–$43.473
GA$37.60–$41.772
GU$45.381
HI$45.381
IA$37.841
ID$38.061
IL$38.55–$42.554
IN$38.301
KS$37.551
KY$37.321
LA$37.21–$39.202
MA$42.83–$47.782
MD$41.50–$47.483
ME$38.16–$40.542
MI$38.26–$40.372
MN$41.581
MO$36.46–$39.483
MS$36.271
MT$41.081
NC$38.601
ND$40.691
NE$38.101
NH$42.371
NJ$44.50–$46.912
NM$38.451
NV$41.001
NY$39.21–$48.425
OH$38.181
OK$37.361
OR$40.75–$44.732
PA$38.31–$42.712
PR$41.441
RI$42.251
SC$38.441
SD$40.641
TN$37.731
TX$38.03–$42.968
UT$39.011
VA$40.32–$47.482
VI$41.441
VT$40.421
WA$42.78–$48.892
WI$39.221
WV$37.001
WY$40.911

See 88304 in every payment locality

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.

How the rate is built · 88304

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.21

0.21 RVUs× 1.000 GPCI

Practice expense1.00

1.00 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

1.2300

Conversion factor

$33.4009

Medicare rate

$41.08

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,203

Code
88304
Physician work
0.21
Practice expense
1.00
Malpractice
0.02

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Office calculation for 88304 in New Mexico
ComponentRVULocality factorAdjusted
Physician work0.21× 1.0000.2100
Practice expense1.00× 0.9170.9170
Malpractice0.02× 1.2010.0240
Total RVUs1.1510
Conversion factor× 33.4009

Office rate, New Mexico$38.45

Office: (0.21 × 1 + 1 × 0.917 + 0.02 × 1.201) × $33.4009 = $38.45

Open 88304 in the RVU calculator

Payment rules and modifiers for 88304

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

CMS payment indicators · 88304

Tissue pathology exam, level III specimen

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

88304 without 26 · national office

$41.08

Tissue pathology exam, level III specimen

88304-26 · Professional component

$10.35

Pays only the interpretation and report.

When to use modifier 26

How 88304 has changed in New Mexico

88304 · Office / nonfacility

$38.45

Effective 2026-10-01

The base rate is $0.03 higher than on 2025-10-01, moving from $38.42 to $38.45 (0.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $38.42changed to$38.45

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.22 changed to 0.21
    • Practice expense RVU 1.04 changed to 1.00
    • Practice expense GPCI 0.908 changed to 0.917
    • Malpractice GPCI 1.172 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $39.84changed to$38.42

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.05 changed to 1.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $39.19changed to$39.84

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $39.73changed to$39.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.03 changed to 1.05
    • Practice expense GPCI 0.902 changed to 0.908
    • Malpractice GPCI 1.169 changed to 1.172
  5. January 1, 2023

    RVU23A

    $38.81changed to$39.73

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.98 changed to 1.03
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 1.166 changed to 1.169

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $38.82changed to$38.81

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.97 changed to 0.98

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $38.96changed to$38.82

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.92 changed to 0.97
    • Practice expense GPCI 0.908 changed to 0.896
    • Malpractice GPCI 1.207 changed to 1.166

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $38.70changed to$38.96

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.90 changed to 0.92
    • Practice expense GPCI 0.921 changed to 0.908
    • Malpractice GPCI 1.247 changed to 1.207

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $39.32changed to$38.70

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.92 changed to 0.90

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $39.14changed to$39.32

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.920 changed to 0.921
    • Malpractice GPCI 1.204 changed to 1.247

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $43.26changed to$39.14

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.05 changed to 0.92
    • Practice expense GPCI 0.919 changed to 0.920
    • Malpractice GPCI 1.161 changed to 1.204

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $43.08changed to$43.26

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.04 changed to 1.05

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $42.87changed to$43.08

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $40.55changed to$42.87

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.97 changed to 1.04
    • Practice expense GPCI 0.918 changed to 0.919
    • Malpractice GPCI 1.079 changed to 1.161

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $41.51changed to$40.55

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.07 changed to 0.97
    • Practice expense GPCI 0.916 changed to 0.918
    • Malpractice GPCI 0.997 changed to 1.079

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $41.51

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$38.45Not available in this settingRVU26D
2026-07-01$38.45Not available in this settingRVU26C
2026-04-01$38.45Not available in this settingRVU26B
2026-01-01$38.45Not available in this settingRVU26A
2025-10-01$38.42Not available in this settingRVU25D
2025-07-01$38.42Not available in this settingRVU25C
2025-04-01$38.42Not available in this settingRVU25B
2025-01-01$38.42Not available in this settingRVU25A
2024-10-01$39.84Not available in this settingRVU24D
2024-07-01$39.84Not available in this settingRVU24C
2024-04-01$39.84Not available in this settingRVU24B
2024-03-09$39.84Not available in this settingRVU24AR
2024-01-01$39.19Not available in this settingRVU24A
2023-10-01$39.73Not available in this settingRVU23D
2023-07-01$39.73Not available in this settingRVU23C
2023-04-01$39.73Not available in this settingRVU23B
2023-01-01$39.73Not available in this settingRVU23A
2022-10-01$38.81Not available in this settingRVU22D
2022-07-01$38.81Not available in this settingRVU22C
2022-04-01$38.81Not available in this settingRVU22B
2022-01-01$38.81Not available in this settingRVU22A
2021-10-01$38.82Not available in this settingRVU21D
2021-07-01$38.82Not available in this settingRVU21C
2021-04-01$38.82Not available in this settingRVU21B
2021-01-01$38.82Not available in this settingRVU21A
2020-10-01$38.96Not available in this settingRVU20D
2020-07-01$38.96Not available in this settingRVU20C
2020-04-01$38.96Not available in this settingRVU20B
2020-01-01$38.96Not available in this settingRVU20A
2019-10-01$38.70Not available in this settingRVU19D
2019-07-01$38.70Not available in this settingRVU19C
2019-04-01$38.70Not available in this settingRVU19B
2019-01-01$38.70Not available in this settingRVU19A
2018-10-01$39.32Not available in this settingRVU18D
2018-07-01$39.32Not available in this settingRVU18C
2018-04-01$39.32Not available in this settingRVU18B
2018-01-01$39.32Not available in this settingRVU18AR1
2017-10-01$39.14Not available in this settingRVU17D
2017-07-01$39.14Not available in this settingRVU17C
2017-04-01$39.14Not available in this settingRVU17B
2017-01-01$39.14Not available in this settingRVU17A
2016-10-01$43.26Not available in this settingRVU16D
2016-07-01$43.26Not available in this settingRVU16C
2016-04-01$43.26Not available in this settingRVU16B
2016-01-01$43.26Not available in this settingRVU16A
2015-10-01$43.08Not available in this settingRVU15D
2015-07-01$43.08Not available in this settingRVU15C
2015-04-01$42.87Not available in this settingRVU15B
2015-01-01$42.87Not available in this settingRVU15A
2014-10-01$40.55Not available in this settingRVU14D
2014-07-01$40.55Not available in this settingRVU14C
2014-04-01$40.55Not available in this settingRVU14B
2014-01-01$40.55Not available in this settingRVU14A
2013-10-01$41.51Not available in this settingRVU13D
2013-07-01$41.51Not available in this settingRVU13C
2013-04-01$41.51Not available in this settingRVU13B
2013-01-01$41.51Not available in this settingRVU13AR

Price 88304 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

88304 billing questions

How is the level chosen between 88304 and 88305?

Select the level assigned to the specimen type in CPT's surgical pathology list. Gallbladders, hemorrhoids, tonsils, and lipomas are Level III; common skin, colon, and stomach biopsies are Level IV under 88305.

How many units are reported when multiple specimens are submitted?

Report one unit for each distinct specimen identified and examined. Two containers do not automatically mean two specimens, and multiple pieces submitted as one specimen count as one unit.

When should modifiers 26 or TC be used?

Use modifier 26 when billing only the pathologist's professional component and modifier TC when billing only the technical component. Report 88304 without either modifier when billing for both components.

Are special stains or decalcification included in 88304?

Routine tissue staining is part of the examination. Separately performed, medically necessary decalcification, special stains, or immunohistochemistry may be reported with appropriate codes such as 88311, 88312, 88313, or 88342.

What if a specimen is not listed in any level?

Select the level whose listed specimens most closely match the physician work for the unlisted specimen, and document its source and findings.

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

Show the CMS file lines behind this rate
RVUs for 88304PPRRVU2026_Oct_nonQPP.csv, line 11,203 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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