CPT code 88304: Tissue pathology exam, level III specimen2026 Medicare rate & RVUs in Texas
Report 88304 for a pathologist's gross and microscopic examination of a Level III surgical specimen, such as a gallbladder, hemorrhoid, or tonsil.
Medicare pays $38.03–$42.96 for 88304 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 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.
Where 88304 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$38.03 to $42.96
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $42.96 | Unavailable |
| Beaumont, TX | $38.03 | Unavailable |
| Brazoria, TX | $40.69 | Unavailable |
| Dallas, TX | $40.92 | Unavailable |
| Fort Worth, TX | $40.59 | Unavailable |
| Galveston, TX | $40.79 | Unavailable |
| Houston, TX | $41.16 | Unavailable |
| Rest of Texas | $39.31 | Unavailable |
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.
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.
88304 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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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