CPT code 88305: Tissue pathology exam, level IV specimen2026 Medicare rate & RVUs in Kentucky
Pathologist gross and microscopic examination of a Level IV specimen, such as a skin, GI tract, breast, or endometrial biopsy.
In Kentucky, Medicare pays $65.08 for 88305 in the office.
Check a contract rate as a % of Medicare · 88305 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 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.
How Kentucky compares for 88305
Across 109 of 109 payment localities, the office rate for 88305 runs from $63.46 in Arkansas to $92.44 in San Benito County, CA. Kentucky pays $65.08. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Kentucky · this page$65.08
- Los Angeles, CA · California$79.17+$14.09
- Washington, DC area · District of Columbia$79.56+$14.48
- Miami, FL · Florida$73.01+$7.93
- Chicago, IL · Illinois$71.40+$6.32
- Manhattan, NY · New York$79.40+$14.32
- Alaska · Alaska$84.96+$19.88
Other areas in Kentucky first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $64.22 | — |
| ArkansasArkansas | $63.46 | — |
| ArizonaArizona | $68.65 | — |
| Bakersfield, CACalifornia | $74.67 | — |
| Chico, CACalifornia | $74.58 | — |
| El Centro, CACalifornia | $74.58 | — |
| Fresno, CACalifornia | $74.58 | — |
| Hanford, CACalifornia | $74.58 | — |
| Madera, CACalifornia | $74.58 | — |
| Merced, CACalifornia | $74.58 | — |
| Modesto, CACalifornia | $74.58 | — |
| Napa, CACalifornia | $85.69 | — |
| Oxnard, CACalifornia | $78.78 | — |
| Redding, CACalifornia | $74.58 | — |
| Rest of CaliforniaCalifornia | $74.58 | — |
| Riverside, CACalifornia | $74.81 | — |
| Sacramento, CACalifornia | $78.06 | — |
| Salinas, CACalifornia | $77.76 | — |
| San Diego, CACalifornia | $79.41 | — |
| Marin County, CACalifornia | $90.58 | — |
| San Francisco, CACalifornia | $90.56 | — |
| San Benito County, CACalifornia | $92.44 | — |
| Santa Clara County, CACalifornia | $92.35 | — |
| San Luis Obispo, CACalifornia | $76.51 | — |
| Santa Cruz, CACalifornia | $80.04 | — |
| Santa Maria, CACalifornia | $78.00 | — |
| Santa Rosa, CACalifornia | $80.84 | — |
| Stockton, CACalifornia | $74.58 | — |
| Vallejo, CACalifornia | $85.66 | — |
| Visalia, CACalifornia | $74.58 | — |
| Yuba City, CACalifornia | $74.58 | — |
| ColoradoColorado | $73.17 | — |
| ConnecticutConnecticut | $74.24 | — |
| DelawareDelaware | $69.66 | — |
| Fort Lauderdale, FLFlorida | $71.27 | — |
| Rest of FloridaFlorida | $68.49 | — |
| Atlanta, GAGeorgia | $71.07 | — |
| Rest of GeorgiaGeorgia | $65.40 | — |
| Hawaii, Guam, HIHawaii | $76.04 | — |
| IowaIowa | $65.91 | — |
| IdahoIdaho | $66.18 | — |
| East St. Louis, ILIllinois | $67.21 | — |
| Rest of IllinoisIllinois | $66.60 | — |
| Suburban Chicago, ILIllinois | $72.05 | — |
| IndianaIndiana | $66.51 | — |
| KansasKansas | $65.48 | — |
| New Orleans, LALouisiana | $67.57 | — |
| Rest of LouisianaLouisiana | $64.93 | — |
| Metropolitan Boston, MAMassachusetts | $79.82 | — |
| Rest of MassachusettsMassachusetts | $72.79 | — |
| Baltimore area, MDMaryland | $73.98 | — |
| Rest of MarylandMaryland | $70.87 | — |
| Rest of MaineMaine | $66.28 | — |
| Southern Maine, MEMaine | $69.49 | — |
| Detroit, MIMichigan | $69.02 | — |
| Rest of MichiganMichigan | $66.31 | — |
| MinnesotaMinnesota | $70.98 | — |
| Metropolitan Kansas City, MOMissouri | $67.38 | — |
| Metropolitan St. Louis, MOMissouri | $67.98 | — |
| Rest of MissouriMissouri | $63.90 | — |
| MississippiMississippi | $63.70 | — |
| MontanaMontana | $70.14 | — |
| North CarolinaNorth Carolina | $66.88 | — |
| North DakotaNorth Dakota | $69.75 | — |
| NebraskaNebraska | $66.25 | — |
| New HampshireNew Hampshire | $71.91 | — |
| Northern New JerseyNew Jersey | $78.94 | — |
| Rest of New JerseyNew Jersey | $75.33 | — |
| New MexicoNew Mexico | $66.53 | — |
| NevadaNevada | $70.08 | — |
| NYC suburbs and Long Island, NYNew York | $80.80 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $75.66 | — |
| Queens, NYNew York | $80.20 | — |
| Rest of New YorkNew York | $67.69 | — |
| OhioOhio | $66.22 | — |
| OklahomaOklahoma | $65.17 | — |
| Portland, OROregon | $75.37 | — |
| Rest of OregonOregon | $69.76 | — |
| Metropolitan Philadelphia, PAPennsylvania | $72.56 | — |
| Rest of PennsylvaniaPennsylvania | $66.41 | — |
| Puerto RicoPuerto Rico | $70.63 | — |
| Rhode IslandRhode Island | $72.02 | — |
| South CarolinaSouth Carolina | $66.61 | — |
| South DakotaSouth Dakota | $69.70 | — |
| TennesseeTennessee | $65.73 | — |
| Austin, TXTexas | $72.73 | — |
| Beaumont, TXTexas | $66.04 | — |
| Brazoria, TXTexas | $69.78 | — |
| Dallas, TXTexas | $70.09 | — |
| Fort Worth, TXTexas | $69.64 | — |
| Galveston, TXTexas | $69.91 | — |
| Houston, TXTexas | $70.27 | — |
| Rest of TexasTexas | $67.78 | — |
| UtahUtah | $67.37 | — |
| VirginiaVirginia | $69.18 | — |
| Virgin Islands, VIUnited States Virgin Islands | $70.63 | — |
| VermontVermont | $69.36 | — |
| Rest of WashingtonWashington | $72.69 | — |
| King County, WAWashington | $81.47 | — |
| WisconsinWisconsin | $67.79 | — |
| West VirginiaWest Virginia | $64.52 | — |
| WyomingWyoming | $69.97 | — |
88305 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.
$63.46
$84.96
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 | $84.96 | 1 |
| AL | $64.22 | 1 |
| AR | $63.46 | 1 |
| AZ | $68.65 | 1 |
| CA | $74.58–$92.44 | 29 |
| CO | $73.17 | 1 |
| CT | $74.24 | 1 |
| DC | $79.56 | 1 |
| DE | $69.66 | 1 |
| FL | $68.49–$73.01 | 3 |
| GA | $65.40–$71.07 | 2 |
| GU | $76.04 | 1 |
| HI | $76.04 | 1 |
| IA | $65.91 | 1 |
| ID | $66.18 | 1 |
| IL | $66.60–$72.05 | 4 |
| IN | $66.51 | 1 |
| KS | $65.48 | 1 |
| KY | $65.08 | 1 |
| LA | $64.93–$67.57 | 2 |
| MA | $72.79–$79.82 | 2 |
| MD | $70.87–$79.56 | 3 |
| ME | $66.28–$69.49 | 2 |
| MI | $66.31–$69.02 | 2 |
| MN | $70.98 | 1 |
| MO | $63.90–$67.98 | 3 |
| MS | $63.70 | 1 |
| MT | $70.14 | 1 |
| NC | $66.88 | 1 |
| ND | $69.75 | 1 |
| NE | $66.25 | 1 |
| NH | $71.91 | 1 |
| NJ | $75.33–$78.94 | 2 |
| NM | $66.53 | 1 |
| NV | $70.08 | 1 |
| NY | $67.69–$80.80 | 5 |
| OH | $66.22 | 1 |
| OK | $65.17 | 1 |
| OR | $69.76–$75.37 | 2 |
| PA | $66.41–$72.56 | 2 |
| PR | $70.63 | 1 |
| RI | $72.02 | 1 |
| SC | $66.61 | 1 |
| SD | $69.70 | 1 |
| TN | $65.73 | 1 |
| TX | $66.04–$72.73 | 8 |
| UT | $67.37 | 1 |
| VA | $69.18–$79.56 | 2 |
| VI | $70.63 | 1 |
| VT | $69.36 | 1 |
| WA | $72.69–$81.47 | 2 |
| WI | $67.79 | 1 |
| WV | $64.52 | 1 |
| WY | $69.97 | 1 |
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.
How the rate is built · 88305
RVUs × geographic indexes × conversion factor
Work0.73
0.73 RVUs× 1.000 GPCI
Practice expense1.35
1.35 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
2.1000
Conversion factor
$33.4009
Medicare rate
$70.14
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Kentucky inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
11,206
- Code
- 88305
- Physician work
- 0.73
- Practice expense
- 1.35
- Malpractice
- 0.02
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.73 | × 1.000 | 0.7300 |
| Practice expense | 1.35 | × 0.889 | 1.2002 |
| Malpractice | 0.02 | × 0.915 | 0.0183 |
| Total RVUs | 1.9485 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Kentucky$65.08
Office: (0.73 × 1 + 1.35 × 0.889 + 0.02 × 0.915) × $33.4009 = $65.08
Payment rules and modifiers for 88305
The CMS indicators that decide how 88305 is paid alongside other services.
CMS payment indicators · 88305
Tissue pathology exam, level IV 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
88305 without 26 · national office
$70.14
Tissue pathology exam, level IV specimen
88305-26 · Professional component
$35.07
Pays only the interpretation and report.
How 88305 has changed in Kentucky
88305 · Office / nonfacility
$65.08
Effective 2026-10-01
The base rate is $1.08 higher than on 2025-10-01, moving from $64.00 to $65.08 (1.7%).
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
$64.00changed to$65.08
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.75 changed to 0.73
- Practice expense RVU 1.38 changed to 1.35
- Practice expense GPCI 0.877 changed to 0.889
- Malpractice GPCI 0.913 changed to 0.915
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$65.86changed to$64.00
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$64.79changed to$65.86
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$65.94changed to$64.79
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.35 changed to 1.38
- Practice expense GPCI 0.873 changed to 0.877
- Malpractice GPCI 0.870 changed to 0.913
January 1, 2023
RVU23A
$65.92changed to$65.94
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.31 changed to 1.35
- Practice expense GPCI 0.869 changed to 0.873
- Malpractice GPCI 0.827 changed to 0.870
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$65.56changed to$65.92
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.28 changed to 1.31
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$65.83changed to$65.56
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.21 changed to 1.28
- Practice expense GPCI 0.874 changed to 0.869
- Malpractice GPCI 0.823 changed to 0.827
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$65.02changed to$65.83
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.17 changed to 1.21
- Malpractice RVU 0.03 changed to 0.02
- Practice expense GPCI 0.880 changed to 0.874
- Malpractice GPCI 0.819 changed to 0.823
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$64.95changed to$65.02
- Conversion factor 35.9996 changed to 36.0391
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$64.25changed to$64.95
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.16 changed to 1.17
- Practice expense GPCI 0.876 changed to 0.880
- Malpractice GPCI 0.807 changed to 0.819
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$67.98changed to$64.25
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.29 changed to 1.16
- Practice expense GPCI 0.872 changed to 0.876
- Malpractice GPCI 0.795 changed to 0.807
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$67.32changed to$67.98
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.27 changed to 1.29
- Malpractice RVU 0.02 changed to 0.03
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$66.98changed to$67.32
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$64.91changed to$66.98
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.20 changed to 1.27
- Malpractice GPCI 0.774 changed to 0.795
Held through RVU15B.
January 1, 2014
RVU14A
$64.26changed to$64.91
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 1.29 changed to 1.20
- Practice expense GPCI 0.871 changed to 0.872
- Malpractice GPCI 0.752 changed to 0.774
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $64.26
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $65.08 | Not available in this setting | RVU26D |
| 2026-07-01 | $65.08 | Not available in this setting | RVU26C |
| 2026-04-01 | $65.08 | Not available in this setting | RVU26B |
| 2026-01-01 | $65.08 | Not available in this setting | RVU26A |
| 2025-10-01 | $64.00 | Not available in this setting | RVU25D |
| 2025-07-01 | $64.00 | Not available in this setting | RVU25C |
| 2025-04-01 | $64.00 | Not available in this setting | RVU25B |
| 2025-01-01 | $64.00 | Not available in this setting | RVU25A |
| 2024-10-01 | $65.86 | Not available in this setting | RVU24D |
| 2024-07-01 | $65.86 | Not available in this setting | RVU24C |
| 2024-04-01 | $65.86 | Not available in this setting | RVU24B |
| 2024-03-09 | $65.86 | Not available in this setting | RVU24AR |
| 2024-01-01 | $64.79 | Not available in this setting | RVU24A |
| 2023-10-01 | $65.94 | Not available in this setting | RVU23D |
| 2023-07-01 | $65.94 | Not available in this setting | RVU23C |
| 2023-04-01 | $65.94 | Not available in this setting | RVU23B |
| 2023-01-01 | $65.94 | Not available in this setting | RVU23A |
| 2022-10-01 | $65.92 | Not available in this setting | RVU22D |
| 2022-07-01 | $65.92 | Not available in this setting | RVU22C |
| 2022-04-01 | $65.92 | Not available in this setting | RVU22B |
| 2022-01-01 | $65.92 | Not available in this setting | RVU22A |
| 2021-10-01 | $65.56 | Not available in this setting | RVU21D |
| 2021-07-01 | $65.56 | Not available in this setting | RVU21C |
| 2021-04-01 | $65.56 | Not available in this setting | RVU21B |
| 2021-01-01 | $65.56 | Not available in this setting | RVU21A |
| 2020-10-01 | $65.83 | Not available in this setting | RVU20D |
| 2020-07-01 | $65.83 | Not available in this setting | RVU20C |
| 2020-04-01 | $65.83 | Not available in this setting | RVU20B |
| 2020-01-01 | $65.83 | Not available in this setting | RVU20A |
| 2019-10-01 | $65.02 | Not available in this setting | RVU19D |
| 2019-07-01 | $65.02 | Not available in this setting | RVU19C |
| 2019-04-01 | $65.02 | Not available in this setting | RVU19B |
| 2019-01-01 | $65.02 | Not available in this setting | RVU19A |
| 2018-10-01 | $64.95 | Not available in this setting | RVU18D |
| 2018-07-01 | $64.95 | Not available in this setting | RVU18C |
| 2018-04-01 | $64.95 | Not available in this setting | RVU18B |
| 2018-01-01 | $64.95 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $64.25 | Not available in this setting | RVU17D |
| 2017-07-01 | $64.25 | Not available in this setting | RVU17C |
| 2017-04-01 | $64.25 | Not available in this setting | RVU17B |
| 2017-01-01 | $64.25 | Not available in this setting | RVU17A |
| 2016-10-01 | $67.98 | Not available in this setting | RVU16D |
| 2016-07-01 | $67.98 | Not available in this setting | RVU16C |
| 2016-04-01 | $67.98 | Not available in this setting | RVU16B |
| 2016-01-01 | $67.98 | Not available in this setting | RVU16A |
| 2015-10-01 | $67.32 | Not available in this setting | RVU15D |
| 2015-07-01 | $67.32 | Not available in this setting | RVU15C |
| 2015-04-01 | $66.98 | Not available in this setting | RVU15B |
| 2015-01-01 | $66.98 | Not available in this setting | RVU15A |
| 2014-10-01 | $64.91 | Not available in this setting | RVU14D |
| 2014-07-01 | $64.91 | Not available in this setting | RVU14C |
| 2014-04-01 | $64.91 | Not available in this setting | RVU14B |
| 2014-01-01 | $64.91 | Not available in this setting | RVU14A |
| 2013-10-01 | $64.26 | Not available in this setting | RVU13D |
| 2013-07-01 | $64.26 | Not available in this setting | RVU13C |
| 2013-04-01 | $64.26 | Not available in this setting | RVU13B |
| 2013-01-01 | $64.26 | Not available in this setting | RVU13AR |
Where the Kentucky rate applies
Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.
88305 billing questions
How many units are reported when a patient has several biopsies?
Report one unit for each separately submitted specimen, such as biopsies from different colon sites submitted in distinct containers. Multiple pieces of tissue submitted together as one specimen count as one unit.
When is modifier 26 appended?
Append 26 when the pathologist bills only the interpretation, such as when a hospital laboratory processes the slides. The entity billing only the technical work uses TC; an entity billing both components uses no component modifier.
Are special stains or immunostains included?
Routine H&E staining is included. Separately performed and documented special stains (88312, 88313), immunohistochemistry (88342, 88341), or decalcification (88311) may be reported when medically necessary.
How is a Medicare prostate needle biopsy reported?
Report one unit of G0416 for the prostate needle biopsy case, regardless of the number of cores or specimens, rather than per-specimen 88305.
Can a skin cyst be billed at this level?
Skin cysts, tags, and debridements are assigned to Level III (88304). Select 88305 for skin biopsies and excisions classified at Level IV rather than assigning a level based on whether margins are assessed.
What documentation supports the level?
The report should identify each specimen separately, include gross findings and the microscopic diagnosis, and specify the anatomic site so the specimen type supports the Level IV assignment.
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
Fee sheets
Put 88305 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →