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

In Queens, NY, Medicare pays $80.20 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.

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 Queens, NY 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. Queens, NY pays $80.20. The RVUs are the same everywhere; the geographic indexes change the dollars.

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88305 rates by state

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

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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

Codes related to 88305

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 88305 has changed in Queens, NY

Price 88305 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

• 88305 in New York · multiple payment areas

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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