$37.60–$41.77
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.
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CMS RVU26D · Effective 2026-10-01
88305 Tissue pathology exam Medicare reimbursement rates in Georgia
Pathologist gross and microscopic examination of a Level IV specimen, such as a skin, GI tract, breast, or endometrial biopsy. Compare 88305 office and facility rates across CMS payment localities in Georgia.
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 88305 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$65.40–$71.07
2 of 2 localities have a supported rate.
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 88305: Level IV surgical pathology, gross and microscopic examination
Pathologist gross and microscopic examination of a Level IV specimen, such as a skin, GI tract, breast, or endometrial biopsy.
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.
CMS billing rules for 88305
- 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 RVU0.73 · 35%
- Practice expense (office) RVU1.35 · 64%
- Malpractice RVU0.02 · 1%
18.4M
Medicare services in 2024 · #11 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.
88305 compared with similar codes
Office rates for Georgia, from the same CMS release.
$254.18–$282.10
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.
$15.09–$16.72
88300 is gross examination only, without microscopic evaluation. When slides are prepared and read, report the appropriate gross and microscopic examination level instead.
$331.96–$361.58
For Medicare prostate needle biopsies, report G0416 for the biopsy case instead of billing 88305 separately for each core or specimen.
Compare 88305 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.
2 of 2 payment localities
Atlanta →
Office / nonfacility
$71.07
Facility
Unavailable
Rest Of Georgia →
Office / nonfacility
$65.40
Facility
Unavailable
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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 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.
11,20388304,,Tissue exam by pathologist,A,,0.21,1.00,,1.00,NA,0.02,1.23,1.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,20488304,26,Tissue exam by pathologist,A,,0.21,0.09,,0.09,,0.01,0.31,0.31,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,20588304,TC,Tissue exam by pathologist,A,,0.00,0.91,,0.91,NA,0.01,0.92,0.92,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,20688305,,Tissue exam by pathologist,A,,0.73,1.35,,1.35,NA,0.02,2.10,2.10,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,20788305,26,Tissue exam by pathologist,A,,0.73,0.31,,0.31,,0.01,1.05,1.05,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,20888305,TC,Tissue exam by pathologist,A,,0.00,1.04,,1.04,NA,0.01,1.05,1.05,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,20988307,,Tissue exam by pathologist,A,,1.55,6.70,,6.70,NA,0.07,8.32,8.32,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00