$48.70
Choose 80504 when the consultation meets moderate medical decision-making or the 21–40-minute time range; 80503 is the straightforward, 5–20-minute level.
On this page
CMS RVU26D · Effective 2026-10-01
80503 Pathology consultation Medicare reimbursement rates in Idaho
Reports a pathologist’s straightforward clinical consultation to assess patient-specific laboratory findings and advise the treating clinician, generally over 5–20 minutes. Compare 80503 office and facility rates across CMS payment localities in Idaho.
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 80503 in Idaho?
Idaho 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
$25.13
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
$17.75
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
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.
Clinical pathology
About 80503: Pathology clinical consultation, straightforward
Reports a pathologist’s straightforward clinical consultation to assess patient-specific laboratory findings and advise the treating clinician, generally over 5–20 minutes.
A clinical pathology consultation is a pathologist’s assessment of patient-specific laboratory information in response to a clinical question. The pathologist may review test results and relevant medical records, consider whether additional testing is appropriate, and communicate an interpretation or recommendation to the treating clinician. Consultations commonly address unclear, conflicting, or unexpected laboratory findings; the service is the pathologist’s clinical reasoning and advice, not the performance of the laboratory tests themselves.
Choose this level when the consultation meets the straightforward medical decision-making description or the stated 5–20-minute time range. Document the requesting clinician’s question, the relevant records and results reviewed, the pathologist’s analysis, and the advice communicated. When selecting by time, record the consultation time supporting the level. Report a higher-level family code when the consultation’s decision-making or time fits that code instead.
Where the value comes from
- Work RVU0.43 · 54%
- Practice expense (office) RVU0.34 · 43%
- Malpractice RVU0.02 · 3%
23.8K
Medicare services in 2024 · #1068 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.
80503 compared with similar codes
Office rates for Idaho, from the same CMS release.
$89.88
Choose 80505 for high medical decision-making or the 41–60-minute time range. A straightforward consultation fits 80503 instead.
$39.80
80506 identifies prolonged service within this consultation family. 80503 describes the straightforward base consultation level and its stated time range.
Compare 80503 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
Idaho →
Office / nonfacility
$25.13
Facility
$17.75
Need rates for a whole code list?
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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 80503 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
9,734
- Code
- 80503
- Physician work
- 0.43
- Practice expense
- 0.34
- Malpractice
- 0.02
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.43 | × 1.000 | 0.4300 |
| Practice expense | 0.34 | × 0.920 | 0.3128 |
| Malpractice | 0.02 | × 0.473 | 0.0095 |
| Total RVUs | 0.7523 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$25.13
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.43 | 1 |
| Practice expense | 0.34 | 0.92 |
| Malpractice | 0.02 | 0.473 |
(0.43 × 1 + 0.34 × 0.92 + 0.02 × 0.473) × $33.4009 = $25.13
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.43 | 1 |
| Practice expense | 0.1 | 0.92 |
| Malpractice | 0.02 | 0.473 |
(0.43 × 1 + 0.1 × 0.92 + 0.02 × 0.473) × $33.4009 = $17.75
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.
80503 billing questions
How does 80503 differ from 80504?
80503 is for a straightforward consultation with 5–20 minutes of service. Use 80504 when the consultation meets the moderate medical decision-making level or its stated 21–40-minute time range.
Can 80503 be reported for routine laboratory result review?
The service is a patient-specific clinical consultation, not routine review associated with laboratory testing. Document the clinical question and the pathologist’s consultative assessment and advice.
What should the consultation documentation show?
Record who requested the consultation, the clinical issue, the relevant results and records reviewed, the pathologist’s reasoning, and the recommendation communicated. Include time when using time to support code selection.
Does 80503 include performing the laboratory test?
No. It represents the pathologist’s consultative work; it is not a code for collecting a specimen, running an assay, or reporting the test result alone.
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.
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4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772