88305 covers routine surgical pathology examination of a specimen. 88355 applies when quantitative morphometric analysis of skeletal muscle is also performed.
On this page
CMS RVU26D · Effective 2026-10-01
88355 Muscle analysis Medicare reimbursement rates in Colorado
Reports quantitative morphometric measurement of skeletal muscle biopsy tissue, typically when evaluating suspected myopathic or neurogenic disease beyond routine histologic examination. Compare 88355 office and facility rates across CMS payment localities in Colorado.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 88355 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$145.85
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Surgical pathology
About 88355: Skeletal muscle morphometric analysis
Reports quantitative morphometric measurement of skeletal muscle biopsy tissue, typically when evaluating suspected myopathic or neurogenic disease beyond routine histologic examination.
A pathology laboratory performs quantitative morphometric assessment of skeletal muscle tissue, commonly from a biopsy obtained during evaluation of suspected myopathy, muscular dystrophy, or neurogenic muscle change. The analysis measures histologic muscle-fiber features; a pathologist interprets the findings in the context of the tissue and clinical question. It may be performed in a hospital laboratory or an independent pathology laboratory.
Report 88355 when skeletal muscle morphometric analysis is performed in addition to routine tissue examination, not for routine microscopic review alone. The report should identify the specimen and document the quantitative analysis and findings. CMS recognizes a professional component for interpretation and a technical component for the equipment and staff performing the test. Report modifier 26 for the professional component, modifier TC for the technical component, or neither modifier for the global service.
CMS billing rules for 88355
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU1.80 · 43%
- Practice expense (office) RVU2.37 · 56%
- Malpractice RVU0.03 · 1%
139
Medicare services in 2024 · #4614 by national volume
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.
88355 compared with similar codes
Office rates for Colorado, from the same CMS release.
Compare 88355 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$145.85
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 88355 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
11,266
- Code
- 88355
- Physician work
- 1.80
- Practice expense
- 2.37
- Malpractice
- 0.03
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.80 | × 1.012 | 1.8216 |
| Practice expense | 2.37 | × 1.064 | 2.5217 |
| Malpractice | 0.03 | × 0.781 | 0.0234 |
| Total RVUs | 4.3667 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$145.85
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.8 | 1.012 |
| Practice expense | 2.37 | 1.064 |
| Malpractice | 0.03 | 0.781 |
(1.8 × 1.012 + 2.37 × 1.064 + 0.03 × 0.781) × $33.4009 = $145.85
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
88355 billing questions
How is 88355 different from routine muscle biopsy pathology?
Routine microscopic examination evaluates the biopsy for diagnosis. 88355 represents additional quantitative morphometric analysis of skeletal muscle tissue, so the record should support that distinct analysis.
When should 88355 be chosen instead of 88356?
Use 88355 for morphometric analysis of skeletal muscle. 88356 is the related analysis code for nerve tissue.
Can 88355 be reported with the muscle biopsy pathology code?
Both may be reported when the muscle biopsy receives routine surgical pathology examination and a separately performed morphometric analysis. The documentation should show both services.
Which modifiers identify the components?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.
What documentation supports 88355?
Document the skeletal muscle specimen, the quantitative morphometric work performed, the findings, and the pathologist's interpretation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
