Billing code 88381: MicrodissectionMedicare rate & RVUs in Guam
Reports manual microscopic separation of a target cell population from tissue, commonly to prepare tumor-rich material for molecular analysis.
Medicare pays $210.12 for 88381 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
What 88381 covers
A pathology laboratory uses manual microscopic techniques to isolate a selected area or cell population from a tissue specimen. For example, a technologist may separate tumor-rich regions from surrounding non-tumor tissue in a prepared section before molecular testing. The service is distinct from gross trimming: the target is selected at the microscopic level, often with pathologist guidance, rather than by cutting the specimen at the bench based only on its gross appearance.
Report 88381 for the manual microdissection work, not for the downstream molecular assay itself. Documentation should identify the tissue and target population, support why microscopic separation was performed, and show that the work was manual rather than laser-based. CMS recognizes professional and technical components: the professional portion may be reported with modifier 26, the technical portion with modifier TC, and billing without either modifier represents 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.
88381 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $210.12 | Unavailable |
How the 88381 rate is calculated
Each of 88381’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 · 88381
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.52Practice expense 5.05Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 88381
The CMS indicators that decide how 88381 is paid alongside other services.
CMS payment indicators · 88381
Microdissection
| 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
88381 without 26 · national office
$187.71
Microdissection
88381-26 · Professional component
$22.04
Pays only the interpretation and report.
88381 compared with similar codes
Compare codes
88381 vs 88380 vs 88387 vs 88363: national Medicare rates
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How to choose
- 88380Tissue microdissection
- Both involve microdissection, but 88381 is for manual separation and 88380 is for laser-based separation.
- 88387Tissue preparation
- 88387 covers macroscopic examination and preparation of tissue for molecular analysis. Choose 88381 when the target is separated through microscopic, manual work.
- 88363Tissue preparation
- 88363 concerns examination and selection of retrieved archived tissue for molecular analysis; 88381 describes manual microscopic separation of a tissue target.
88381 billing questions
When should 88381 be chosen instead of 88380?
Use 88381 when the target tissue is separated manually under microscopic guidance. Use 88380 when laser microdissection is performed.
Does 88381 include the molecular test?
No. It represents the manual tissue preparation, not the subsequent molecular analysis; report a separately performed assay under its applicable code.
How are the professional and technical portions reported?
Modifier 26 identifies the professional portion, and modifier TC identifies the technical portion. Reporting without either modifier represents the global service.
What documentation supports reporting 88381?
Document the specimen, the target cell population or tissue area, and the manual microscopic separation performed. The record should make clear that this was not laser microdissection or gross tissue trimming.
Is 88381 used for gross selection of tissue?
No. Manual microdissection targets tissue at the microscopic level; gross examination and preparation for molecular analysis is a different service.
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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