Billing code 88323: Pathology consultationMedicare rate & RVUs
A pathologist prepares slides from referred tissue material, examines it for an outside diagnostic opinion, and reports findings when already-prepared slides are insufficient.
Medicare pays $112.90 for 88323 nationally in the office. Local office rates run $105.13–$145.75.
Medicare rate · 88323
Pathology consultation
Swap in your local Medicare rate.
- Work RVUs
- 1.78
- Total RVUs
- 3.38
- Global days
- XXX
National rate · 2026
$112.90
Office setting, before claim adjustments.
See every locality for 88323 → · Billed by an NP, PA or therapist? →
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 10 sections
What 88323 covers
A pathologist uses 88323 when another facility or clinician sends tissue material for an outside diagnostic opinion and slide preparation is needed before review. The pathologist may prepare sections from a referred tissue block, examine the resulting slides, and issue a consultation report. This service can support a second opinion on a biopsy or resection when specialist review may affect diagnosis or treatment planning. It is commonly performed in a hospital or independent pathology laboratory.
Report 88323 for consultation on referred material when slide preparation is required. Use 88321 when the referred slides are already prepared; 88325 describes a comprehensive consultation that includes record review. Documentation should identify the material received, preparation performed, interpretation, and consultation report. CMS recognizes a professional component for interpretation and a technical component for equipment and staff. Report modifier 26 for the professional component, TC for the technical component, or neither modifier for the global service.
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 88323 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$105.13 to $145.75
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $106.01 | Unavailable |
| Alaska* | $145.75 | Unavailable |
| Arizona | $111.16 | Unavailable |
| Arkansas | $105.13 | Unavailable |
| Atlanta | $114.05 | Unavailable |
| Austin | $116.00 | Unavailable |
| Bakersfield | $118.83 | Unavailable |
| Baltimore/Surr. Cntys | $117.86 | Unavailable |
| Beaumont | $108.10 | Unavailable |
| Brazoria | $112.75 | Unavailable |
| Chicago | $114.44 | Unavailable |
| Chico | $118.66 | Unavailable |
| Colorado | $116.84 | Unavailable |
| Connecticut | $118.29 | Unavailable |
| Dallas | $113.12 | Unavailable |
| Dc + Md/Va Suburbs | $125.57 | Unavailable |
| Delaware | $112.49 | Unavailable |
| Detroit | $111.51 | Unavailable |
| East St. Louis | $109.35 | Unavailable |
| El Centro | $118.67 | Unavailable |
| Fort Lauderdale | $114.12 | Unavailable |
| Fort Worth | $112.61 | Unavailable |
| Fresno | $118.66 | Unavailable |
| Galveston | $112.89 | Unavailable |
| Hanford-Corcoran | $118.66 | Unavailable |
| Hawaii, Guam | $119.84 | Unavailable |
| Houston | $113.25 | Unavailable |
| Idaho | $108.32 | Unavailable |
| Indiana | $108.70 | Unavailable |
| Iowa | $108.01 | Unavailable |
| Kansas | $107.50 | Unavailable |
| Kentucky | $106.98 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $124.77 | Unavailable |
| Madera | $118.66 | Unavailable |
| Manhattan | $125.64 | Unavailable |
| Merced | $118.66 | Unavailable |
| Metropolitan Boston | $125.50 | Unavailable |
| Metropolitan Kansas City | $109.66 | Unavailable |
| Metropolitan Philadelphia | $116.26 | Unavailable |
| Metropolitan St. Louis | $110.36 | Unavailable |
| Miami | $116.08 | Unavailable |
| Minnesota | $113.96 | Unavailable |
| Mississippi | $105.39 | Unavailable |
| Modesto | $118.66 | Unavailable |
| Montana** | $112.89 | Unavailable |
| Napa | $133.09 | Unavailable |
| Nebraska | $108.42 | Unavailable |
| Nevada** | $112.84 | Unavailable |
| New Hampshire | $114.98 | Unavailable |
| New Mexico | $108.65 | Unavailable |
| New Orleans | $109.87 | Unavailable |
| North Carolina | $109.12 | Unavailable |
| North Dakota** | $112.50 | Unavailable |
| Northern Nj | $125.13 | Unavailable |
| Nyc Suburbs/Long Island | $127.25 | Unavailable |
| Ohio | $108.31 | Unavailable |
| Oklahoma | $107.10 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $123.91 | Unavailable |
| Portland | $119.53 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $120.72 | Unavailable |
| Puerto Rico | $113.47 | Unavailable |
| Queens | $126.60 | Unavailable |
| Redding | $118.66 | Unavailable |
| Rest Of California | $118.66 | Unavailable |
| Rest Of Florida | $110.91 | Unavailable |
| Rest Of Georgia | $107.32 | Unavailable |
| Rest Of Illinois | $108.68 | Unavailable |
| Rest Of Louisiana | $106.80 | Unavailable |
| Rest Of Maine | $108.42 | Unavailable |
| Rest Of Maryland | $114.07 | Unavailable |
| Rest Of Massachusetts | $116.51 | Unavailable |
| Rest Of Michigan | $108.39 | Unavailable |
| Rest Of Missouri | $105.59 | Unavailable |
| Rest Of New Jersey | $120.19 | Unavailable |
| Rest Of New York | $110.06 | Unavailable |
| Rest Of Oregon | $112.49 | Unavailable |
| Rest Of Pennsylvania | $108.53 | Unavailable |
| Rest Of Texas | $110.14 | Unavailable |
| Rest Of Washington | $116.31 | Unavailable |
| Rhode Island | $115.69 | Unavailable |
| Riverside-San Bernardino-Ontario | $118.93 | Unavailable |
| Sacramento-Roseville-Folsom | $123.33 | Unavailable |
| Salinas | $122.82 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $124.72 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $139.82 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $139.80 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $142.45 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $142.36 | Unavailable |
| San Luis Obispo-Paso Robles | $120.93 | Unavailable |
| Santa Cruz-Watsonville | $125.18 | Unavailable |
| Santa Maria-Santa Barbara | $123.01 | Unavailable |
| Santa Rosa-Petaluma | $126.40 | Unavailable |
| Seattle (King Cnty) | $127.73 | Unavailable |
| South Carolina | $108.78 | Unavailable |
| South Dakota** | $112.45 | Unavailable |
| Southern Maine | $112.17 | Unavailable |
| Stockton | $118.66 | Unavailable |
| Suburban Chicago | $115.25 | Unavailable |
| Tennessee | $107.78 | Unavailable |
| Utah | $109.66 | Unavailable |
| Vallejo | $133.06 | Unavailable |
| Vermont | $112.04 | Unavailable |
| Virgin Islands | $113.47 | Unavailable |
| Virginia | $111.80 | Unavailable |
| Visalia | $118.66 | Unavailable |
| West Virginia | $106.27 | Unavailable |
| Wisconsin | $110.22 | Unavailable |
| Wyoming** | $112.72 | Unavailable |
| Yuba City | $118.66 | Unavailable |
88323 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.
$105.13
$145.75
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 | $145.75 | 1 |
| AL | $106.01 | 1 |
| AR | $105.13 | 1 |
| AZ | $111.16 | 1 |
| CA | $118.66–$142.45 | 29 |
| CO | $116.84 | 1 |
| CT | $118.29 | 1 |
| DC | $125.57 | 1 |
| DE | $112.49 | 1 |
| FL | $110.91–$116.08 | 3 |
| GA | $107.32–$114.05 | 2 |
| GU | $119.84 | 1 |
| HI | $119.84 | 1 |
| IA | $108.01 | 1 |
| ID | $108.32 | 1 |
| IL | $108.68–$115.25 | 4 |
| IN | $108.70 | 1 |
| KS | $107.50 | 1 |
| KY | $106.98 | 1 |
| LA | $106.80–$109.87 | 2 |
| MA | $116.51–$125.50 | 2 |
| MD | $114.07–$125.57 | 3 |
| ME | $108.42–$112.17 | 2 |
| MI | $108.39–$111.51 | 2 |
| MN | $113.96 | 1 |
| MO | $105.59–$110.36 | 3 |
| MS | $105.39 | 1 |
| MT | $112.89 | 1 |
| NC | $109.12 | 1 |
| ND | $112.50 | 1 |
| NE | $108.42 | 1 |
| NH | $114.98 | 1 |
| NJ | $120.19–$125.13 | 2 |
| NM | $108.65 | 1 |
| NV | $112.84 | 1 |
| NY | $110.06–$127.25 | 5 |
| OH | $108.31 | 1 |
| OK | $107.10 | 1 |
| OR | $112.49–$119.53 | 2 |
| PA | $108.53–$116.26 | 2 |
| PR | $113.47 | 1 |
| RI | $115.69 | 1 |
| SC | $108.78 | 1 |
| SD | $112.45 | 1 |
| TN | $107.78 | 1 |
| TX | $108.10–$116.00 | 8 |
| UT | $109.66 | 1 |
| VA | $111.80–$125.57 | 2 |
| VI | $113.47 | 1 |
| VT | $112.04 | 1 |
| WA | $116.31–$127.73 | 2 |
| WI | $110.22 | 1 |
| WV | $106.27 | 1 |
| WY | $112.72 | 1 |
How the 88323 rate is calculated
Each of 88323’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 · 88323
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.78Practice expense 1.58Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 88323
The CMS indicators that decide how 88323 is paid alongside other services.
CMS payment indicators · 88323
Pathology consultation
| 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
88323 without 26 · national office
$112.90
Pathology consultation
88323-26 · Professional component
$83.17
Pays only the interpretation and report.
88323 compared with similar codes
Compare codes
88323 vs 88321 vs 88325 vs 88305 vs 88329: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 88321Slide consultation
- 88321 is for review of referred slides already prepared elsewhere. Choose 88323 when preparing slides from the referred material is required.
- 88325Pathology consultation
- 88325 describes a comprehensive consultation that includes review of records. 88323 centers on referred material requiring slide preparation.
- 88305Tissue pathology exam
- 88305 is a routine surgical pathology examination of a specimen. 88323 is a consultation on referred material that requires slide preparation.
- 88329Pathology consult
- 88329 is a pathology consultation during surgery. 88323 covers consultation on referred material requiring slide preparation.
88323 billing questions
When should I choose 88323 instead of 88321?
Use 88323 when referred material needs slide preparation for the consultation. Use 88321 when the pathologist reviews slides that were already prepared elsewhere.
How does 88323 differ from 88325?
88323 applies when slide preparation is required for the referred material. 88325 is for a comprehensive consultation that includes review of records.
Can the professional and technical components be billed separately?
Yes. Use modifier 26 for the professional interpretation and report, or TC for the technical work involving equipment and staff. Report the global service without either modifier when both components are furnished.
What documentation supports reporting 88323?
Document the referred material received, the slide preparation performed, the pathologist’s interpretation, and the consultation report.
Is 88323 the same as a routine surgical pathology examination?
No. 88323 is for a consultation on referred material requiring slide preparation. A routine surgical pathology examination, such as 88305, concerns examination of a specimen rather than this referred-material consultation.
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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