$257.46
88307 applies to specimen types designated Level V. 88309 applies to Level VI specimens, including radical hysterectomy and radical prostatectomy specimens.
On this page
CMS RVU26D · Effective 2026-10-01
88309 Tissue pathology Medicare reimbursement rates in Iowa
Reports gross and microscopic examination of designated Level VI radical resection specimens, commonly including major oncologic resections such as radical hysterectomy. Compare 88309 office and facility rates across CMS payment localities in Iowa.
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 88309 in Iowa?
Iowa 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
$384.38
1 of 1 localities have a supported rate.
Payment area: Iowa
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 88309: Radical resection surgical pathology examination
Reports gross and microscopic examination of designated Level VI radical resection specimens, commonly including major oncologic resections such as radical hysterectomy.
A pathologist examines a major resection specimen grossly and microscopically, assessing the removed tissue and relevant margins or associated structures. This level is used for specimen types classified as Level VI, including radical hysterectomy, radical prostatectomy, and radical mastectomy specimens. Hospital and independent pathology laboratories commonly perform the work on tissue removed during surgery.
Select the level by the specimen type and procedure, not simply because the diagnosis is cancer or the examination is complex. The surgical pathology report and requisition should identify the procedure and specimen, with findings supporting the examination performed. Medicare recognizes separate professional and technical components: modifier 26 reports the pathologist’s interpretation, modifier TC reports the technical work, and reporting without either modifier represents the global service.
CMS billing rules for 88309
- 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 RVU2.73 · 22%
- Practice expense (office) RVU9.55 · 77%
- Malpractice RVU0.10 · 1%
127.8K
Medicare services in 2024 · #495 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.
88309 compared with similar codes
Office rates for Iowa, from the same CMS release.
$65.91
88305 is the Level IV examination for its assigned specimen types, often biopsies or smaller excisions. 88309 is reserved for designated Level VI radical resection specimens.
$14.86
88300 covers gross examination only. 88309 represents a Level VI examination that includes gross and microscopic work.
Compare 88309 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
Iowa →
Office / nonfacility
$384.38
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 88309 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
11,212
- Code
- 88309
- Physician work
- 2.73
- Practice expense
- 9.55
- Malpractice
- 0.10
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.73 | × 1.000 | 2.7300 |
| Practice expense | 9.55 | × 0.915 | 8.7383 |
| Malpractice | 0.10 | × 0.397 | 0.0397 |
| Total RVUs | 11.5080 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$384.38
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.73 | 1 |
| Practice expense | 9.55 | 0.915 |
| Malpractice | 0.1 | 0.397 |
(2.73 × 1 + 9.55 × 0.915 + 0.1 × 0.397) × $33.4009 = $384.38
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.
88309 billing questions
How does 88309 differ from 88307?
Use 88309 for specimen types designated Level VI, such as radical hysterectomy or radical prostatectomy specimens. Use 88307 when the specimen type is designated Level V; the diagnosis or perceived complexity alone does not determine the level.
Does a cancer diagnosis by itself support 88309?
No. Choose the code from the specimen type and operation performed. A malignancy diagnosis does not automatically make an examination Level VI.
When should modifier 26 or TC be reported?
Use modifier 26 for the professional interpretation and modifier TC for the technical service. Without either modifier, the claim represents the global service.
What documentation supports this level?
The requisition and pathology report should identify the specimen and the operation performed, such as a radical hysterectomy. The report should document the gross and microscopic examination.
Can special stains be reported with 88309?
A special-stain service is distinct from the Level VI tissue examination and may be reported separately when the applicable code requirements are met. The tissue examination code alone does not establish that a stain service was performed.
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.
11,20988307,,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
11,21088307,26,Tissue exam by pathologist,A,,1.55,0.71,,0.71,,0.03,2.29,2.29,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,21188307,TC,Tissue exam by pathologist,A,,0.00,5.99,,5.99,NA,0.04,6.03,6.03,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,21288309,,Tissue exam by pathologist,A,,2.73,9.55,,9.55,NA,0.10,12.38,12.38,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,21388309,26,Tissue exam by pathologist,A,,2.73,1.25,,1.25,,0.05,4.03,4.03,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,21488309,TC,Tissue exam by pathologist,A,,0.00,8.30,,8.30,NA,0.05,8.35,8.35,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,21588311,,Decalcify tissue,A,,0.23,0.34,,0.34,NA,0.02,0.59,0.59,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136