CPT code 88304: Tissue pathology exam, level III specimen2026 Medicare rate & RVUs in South Dakota
Report 88304 for a pathologist's gross and microscopic examination of a Level III surgical specimen, such as a gallbladder, hemorrhoid, or tonsil.
In South Dakota, Medicare pays $40.64 for 88304 in the office.
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.
On this page 11 sections
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 South Dakota 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. South Dakota pays $40.64. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$40.64
- Los Angeles, CA · California$47.26+$6.62
- Washington, DC area · District of Columbia$47.48+$6.84
- Miami, FL · Florida$43.47+$2.83
- Chicago, IL · Illinois$42.16+$1.52
- Manhattan, NY · New York$47.33+$6.69
- Alaska · Alaska$46.46+$5.82
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 | — |
| Madera, CACalifornia | $44.10 | — |
| Merced, CACalifornia | $44.10 | — |
| Modesto, CACalifornia | $44.10 | — |
| Napa, CACalifornia | $51.82 | — |
| Oxnard, CACalifornia | $47.11 | — |
| Redding, CACalifornia | $44.10 | — |
| Rest of CaliforniaCalifornia | $44.10 | — |
| Riverside, CACalifornia | $44.32 | — |
| Sacramento, CACalifornia | $46.47 | — |
| Salinas, CACalifornia | $46.30 | — |
| San Diego, CACalifornia | $47.53 | — |
| Marin County, CACalifornia | $55.08 | — |
| San Francisco, CACalifornia | $55.06 | — |
| San Benito County, CACalifornia | $56.31 | — |
| Santa Clara County, CACalifornia | $56.22 | — |
| San Luis Obispo, CACalifornia | $45.54 | — |
| Santa Cruz, CACalifornia | $48.10 | — |
| Santa Maria, CACalifornia | $46.51 | — |
| Santa Rosa, CACalifornia | $48.60 | — |
| Stockton, CACalifornia | $44.10 | — |
| Vallejo, CACalifornia | $51.79 | — |
| Visalia, CACalifornia | $44.10 | — |
| Yuba City, CACalifornia | $44.10 | — |
| ColoradoColorado | $43.16 | — |
| ConnecticutConnecticut | $43.94 | — |
| DelawareDelaware | $40.65 | — |
| Fort Lauderdale, FLFlorida | $42.06 | — |
| Rest of FloridaFlorida | $39.95 | — |
| Atlanta, GAGeorgia | $41.77 | — |
| Rest of GeorgiaGeorgia | $37.60 | — |
| Hawaii, Guam, HIHawaii | $45.38 | — |
| IowaIowa | $37.84 | — |
| IdahoIdaho | $38.06 | — |
| East St. Louis, ILIllinois | $39.09 | — |
| Rest of IllinoisIllinois | $38.55 | — |
| Suburban Chicago, ILIllinois | $42.55 | — |
| IndianaIndiana | $38.30 | — |
| KansasKansas | $37.55 | — |
| KentuckyKentucky | $37.32 | — |
| New Orleans, LALouisiana | $39.20 | — |
| Rest of LouisianaLouisiana | $37.21 | — |
| Metropolitan Boston, MAMassachusetts | $47.78 | — |
| Rest of MassachusettsMassachusetts | $42.83 | — |
| Baltimore area, MDMaryland | $43.79 | — |
| Rest of MarylandMaryland | $41.50 | — |
| Rest of MaineMaine | $38.16 | — |
| Southern Maine, MEMaine | $40.54 | — |
| Detroit, MIMichigan | $40.37 | — |
| Rest of MichiganMichigan | $38.26 | — |
| MinnesotaMinnesota | $41.58 | — |
| Metropolitan Kansas City, MOMissouri | $39.03 | — |
| Metropolitan St. Louis, MOMissouri | $39.48 | — |
| Rest of MissouriMissouri | $36.46 | — |
| MississippiMississippi | $36.27 | — |
| MontanaMontana | $41.08 | — |
| North CarolinaNorth Carolina | $38.60 | — |
| North DakotaNorth Dakota | $40.69 | — |
| NebraskaNebraska | $38.10 | — |
| New HampshireNew Hampshire | $42.37 | — |
| Northern New JerseyNew Jersey | $46.91 | — |
| Rest of New JerseyNew Jersey | $44.50 | — |
| New MexicoNew Mexico | $38.45 | — |
| NevadaNevada | $41.00 | — |
| NYC suburbs and Long Island, NYNew York | $48.42 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $44.71 | — |
| Queens, NYNew York | $47.91 | — |
| Rest of New YorkNew York | $39.21 | — |
| OhioOhio | $38.18 | — |
| OklahomaOklahoma | $37.36 | — |
| Portland, OROregon | $44.73 | — |
| Rest of OregonOregon | $40.75 | — |
| Metropolitan Philadelphia, PAPennsylvania | $42.71 | — |
| Rest of PennsylvaniaPennsylvania | $38.31 | — |
| Puerto RicoPuerto Rico | $41.44 | — |
| Rhode IslandRhode Island | $42.25 | — |
| South CarolinaSouth Carolina | $38.44 | — |
| TennesseeTennessee | $37.73 | — |
| Austin, TXTexas | $42.96 | — |
| Beaumont, TXTexas | $38.03 | — |
| Brazoria, TXTexas | $40.69 | — |
| Dallas, TXTexas | $40.92 | — |
| Fort Worth, TXTexas | $40.59 | — |
| Galveston, TXTexas | $40.79 | — |
| Houston, TXTexas | $41.16 | — |
| Rest of TexasTexas | $39.31 | — |
| UtahUtah | $39.01 | — |
| VirginiaVirginia | $40.32 | — |
| Virgin Islands, VIUnited States Virgin Islands | $41.44 | — |
| VermontVermont | $40.42 | — |
| Rest of WashingtonWashington | $42.78 | — |
| King County, WAWashington | $48.89 | — |
| WisconsinWisconsin | $39.22 | — |
| West VirginiaWest Virginia | $37.00 | — |
| WyomingWyoming | $40.91 | — |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $46.46 | 1 |
| AL | $36.62 | 1 |
| AR | $36.05 | 1 |
| AZ | $39.95 | 1 |
| CA | $44.10–$56.31 | 29 |
| CO | $43.16 | 1 |
| CT | $43.94 | 1 |
| DC | $47.48 | 1 |
| DE | $40.65 | 1 |
| FL | $39.95–$43.47 | 3 |
| GA | $37.60–$41.77 | 2 |
| GU | $45.38 | 1 |
| HI | $45.38 | 1 |
| IA | $37.84 | 1 |
| ID | $38.06 | 1 |
| IL | $38.55–$42.55 | 4 |
| IN | $38.30 | 1 |
| KS | $37.55 | 1 |
| KY | $37.32 | 1 |
| LA | $37.21–$39.20 | 2 |
| MA | $42.83–$47.78 | 2 |
| MD | $41.50–$47.48 | 3 |
| ME | $38.16–$40.54 | 2 |
| MI | $38.26–$40.37 | 2 |
| MN | $41.58 | 1 |
| MO | $36.46–$39.48 | 3 |
| MS | $36.27 | 1 |
| MT | $41.08 | 1 |
| NC | $38.60 | 1 |
| ND | $40.69 | 1 |
| NE | $38.10 | 1 |
| NH | $42.37 | 1 |
| NJ | $44.50–$46.91 | 2 |
| NM | $38.45 | 1 |
| NV | $41.00 | 1 |
| NY | $39.21–$48.42 | 5 |
| OH | $38.18 | 1 |
| OK | $37.36 | 1 |
| OR | $40.75–$44.73 | 2 |
| PA | $38.31–$42.71 | 2 |
| PR | $41.44 | 1 |
| RI | $42.25 | 1 |
| SC | $38.44 | 1 |
| SD | $40.64 | 1 |
| TN | $37.73 | 1 |
| TX | $38.03–$42.96 | 8 |
| UT | $39.01 | 1 |
| VA | $40.32–$47.48 | 2 |
| VI | $41.44 | 1 |
| VT | $40.42 | 1 |
| WA | $42.78–$48.89 | 2 |
| WI | $39.22 | 1 |
| WV | $37.00 | 1 |
| WY | $40.91 | 1 |
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
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 South Dakota 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
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.21 | × 1.000 | 0.2100 |
| Practice expense | 1.00 | × 1.000 | 1.0000 |
| Malpractice | 0.02 | × 0.336 | 0.0067 |
| Total RVUs | 1.2167 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$40.64
Office: (0.21 × 1 + 1 × 1 + 0.02 × 0.336) × $33.4009 = $40.64
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
How 88304 has changed in South Dakota
88304 · Office / nonfacility
$40.64
Effective 2026-10-01
The base rate is $0.36 lower than on 2025-10-01, moving from $41.00 to $40.64 (0.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$41.00changed to$40.64
- 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
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$42.53changed to$41.00
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.05 changed to 1.04
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$41.84changed to$42.53
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$42.61changed to$41.84
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.03 changed to 1.05
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$41.77changed to$42.61
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.98 changed to 1.03
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$41.76changed to$41.77
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.97 changed to 0.98
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$41.41changed to$41.76
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.92 changed to 0.97
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$40.64changed to$41.41
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.90 changed to 0.92
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$41.32changed to$40.64
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.92 changed to 0.90
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$41.20changed to$41.32
- Conversion factor 35.8887 changed to 35.9996
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$45.76changed to$41.20
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.05 changed to 0.92
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$45.56changed to$45.76
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.04 changed to 1.05
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$45.34changed to$45.56
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$42.93changed to$45.34
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.97 changed to 1.04
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
$44.18changed to$42.93
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.07 changed to 0.97
- Malpractice GPCI 0.432 changed to 0.416
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $44.18
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $40.64 | Not available in this setting | RVU26D |
| 2026-07-01 | $40.64 | Not available in this setting | RVU26C |
| 2026-04-01 | $40.64 | Not available in this setting | RVU26B |
| 2026-01-01 | $40.64 | Not available in this setting | RVU26A |
| 2025-10-01 | $41.00 | Not available in this setting | RVU25D |
| 2025-07-01 | $41.00 | Not available in this setting | RVU25C |
| 2025-04-01 | $41.00 | Not available in this setting | RVU25B |
| 2025-01-01 | $41.00 | Not available in this setting | RVU25A |
| 2024-10-01 | $42.53 | Not available in this setting | RVU24D |
| 2024-07-01 | $42.53 | Not available in this setting | RVU24C |
| 2024-04-01 | $42.53 | Not available in this setting | RVU24B |
| 2024-03-09 | $42.53 | Not available in this setting | RVU24AR |
| 2024-01-01 | $41.84 | Not available in this setting | RVU24A |
| 2023-10-01 | $42.61 | Not available in this setting | RVU23D |
| 2023-07-01 | $42.61 | Not available in this setting | RVU23C |
| 2023-04-01 | $42.61 | Not available in this setting | RVU23B |
| 2023-01-01 | $42.61 | Not available in this setting | RVU23A |
| 2022-10-01 | $41.77 | Not available in this setting | RVU22D |
| 2022-07-01 | $41.77 | Not available in this setting | RVU22C |
| 2022-04-01 | $41.77 | Not available in this setting | RVU22B |
| 2022-01-01 | $41.77 | Not available in this setting | RVU22A |
| 2021-10-01 | $41.76 | Not available in this setting | RVU21D |
| 2021-07-01 | $41.76 | Not available in this setting | RVU21C |
| 2021-04-01 | $41.76 | Not available in this setting | RVU21B |
| 2021-01-01 | $41.76 | Not available in this setting | RVU21A |
| 2020-10-01 | $41.41 | Not available in this setting | RVU20D |
| 2020-07-01 | $41.41 | Not available in this setting | RVU20C |
| 2020-04-01 | $41.41 | Not available in this setting | RVU20B |
| 2020-01-01 | $41.41 | Not available in this setting | RVU20A |
| 2019-10-01 | $40.64 | Not available in this setting | RVU19D |
| 2019-07-01 | $40.64 | Not available in this setting | RVU19C |
| 2019-04-01 | $40.64 | Not available in this setting | RVU19B |
| 2019-01-01 | $40.64 | Not available in this setting | RVU19A |
| 2018-10-01 | $41.32 | Not available in this setting | RVU18D |
| 2018-07-01 | $41.32 | Not available in this setting | RVU18C |
| 2018-04-01 | $41.32 | Not available in this setting | RVU18B |
| 2018-01-01 | $41.32 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $41.20 | Not available in this setting | RVU17D |
| 2017-07-01 | $41.20 | Not available in this setting | RVU17C |
| 2017-04-01 | $41.20 | Not available in this setting | RVU17B |
| 2017-01-01 | $41.20 | Not available in this setting | RVU17A |
| 2016-10-01 | $45.76 | Not available in this setting | RVU16D |
| 2016-07-01 | $45.76 | Not available in this setting | RVU16C |
| 2016-04-01 | $45.76 | Not available in this setting | RVU16B |
| 2016-01-01 | $45.76 | Not available in this setting | RVU16A |
| 2015-10-01 | $45.56 | Not available in this setting | RVU15D |
| 2015-07-01 | $45.56 | Not available in this setting | RVU15C |
| 2015-04-01 | $45.34 | Not available in this setting | RVU15B |
| 2015-01-01 | $45.34 | Not available in this setting | RVU15A |
| 2014-10-01 | $42.93 | Not available in this setting | RVU14D |
| 2014-07-01 | $42.93 | Not available in this setting | RVU14C |
| 2014-04-01 | $42.93 | Not available in this setting | RVU14B |
| 2014-01-01 | $42.93 | Not available in this setting | RVU14A |
| 2013-10-01 | $44.18 | Not available in this setting | RVU13D |
| 2013-07-01 | $44.18 | Not available in this setting | RVU13C |
| 2013-04-01 | $44.18 | Not available in this setting | RVU13B |
| 2013-01-01 | $44.18 | Not available in this setting | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
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