CPT code 88305: Tissue pathology exam, level IV specimen2026 Medicare rate & RVUs

Medicare pays $70.14 for 88305 nationally in the office. Local office rates run $63.46–$92.44.

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

What 88305 covers

This service covers gross examination and microscopic interpretation of a Level IV tissue specimen, with routine processing, embedding, sectioning, and H&E staining. Common specimens include skin biopsies, gastric and colon biopsies, colorectal polyps, breast core biopsies, endometrial biopsies, and bone marrow core biopsies. Pathologists, including dermatopathologists, examine these specimens in hospital laboratories, independent laboratories, or physician office laboratories.

Report one unit for each separately submitted specimen classified at Level IV; the specimen type, not the number of tissue blocks or slides, determines the level. The pathology report should identify each specimen and its anatomic site, gross findings, and microscopic diagnosis. Separately performed and documented special stains, immunohistochemistry, or decalcification may be reported with the appropriate codes when medically necessary. Without a modifier, 88305 represents the global service. Modifier 26 identifies the pathologist's interpretation and report; modifier TC identifies technical processing, equipment, and staff work. For Medicare prostate needle biopsies, report G0416 for the biopsy case rather than 88305 units for individual cores or specimens.

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 88305 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

88305 rates by state

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

How the 88305 rate is calculated

Each of 88305’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 88305

The CMS indicators that decide how 88305 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

88305 compared with similar codes

How to choose

88304Tissue pathology examLevel III specimen

88304 applies to Level III specimens such as skin cysts, tags, gallbladder, and appendix. Choose 88305 when the submitted specimen type is assigned to Level IV.

88307Tissue pathology examLevel V specimen

88307 covers specimens assigned to Level V, including some biopsies and more extensive resections. Select the level by specimen type, not specimen size or slide count alone.

88300Gross pathologyGross examination only

88300 is gross examination only, without microscopic evaluation. When slides are prepared and read, report the appropriate gross and microscopic examination level instead.

G0416Prostate pathology10–20 specimens

For Medicare prostate needle biopsies, report G0416 for the biopsy case instead of billing 88305 separately for each core or specimen.

Codes related to 88305

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