88305 is Level IV and includes specimens such as prostate needle biopsies. Use 88307 for specimens CPT assigns to Level V, such as liver biopsy or breast lesion excision.
On this page
CMS RVU26D · Effective 2026-10-01
88307 Tissue pathology exam Medicare reimbursement rates in Ohio
Gross and microscopic pathologist examination of a Level V surgical specimen, such as a liver biopsy, cervical cone, or breast lesion excision. Compare 88307 office and facility rates across CMS payment localities in Ohio.
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 88307 in Ohio?
Ohio 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
$258.44
1 of 1 localities have a supported rate.
Payment area: Ohio
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 88307: Level V surgical pathology gross and microscopic exam
Gross and microscopic pathologist examination of a Level V surgical specimen, such as a liver biopsy, cervical cone, or breast lesion excision.
This service covers gross and microscopic examination of a specimen assigned to Level V surgical pathology. Level V includes certain biopsies as well as excisions and resections. Examples include needle or wedge liver biopsies, cervical conization, breast lesion excisions, simple mastectomy, thyroid lobectomy, transurethral resection of a bladder tumor, and lung wedge biopsy. The work is performed in hospital pathology departments and independent laboratories, with a pathologist issuing a signed diagnostic report.
Report one unit for each distinct specimen assigned to Level V, not for each tissue fragment, block, or slide. Select the level from the CPT specimen classification; the report should identify the specimen and document the gross and microscopic findings. CMS prices professional and technical components separately: modifier 26 identifies the pathologist's interpretation and report, and modifier TC identifies laboratory preparation and support. Report the global service without a modifier when one entity provides both components. When separately indicated and documented, additional services such as special stains, immunohistochemistry, decalcification, or intraoperative frozen-section consultation may be reported with the final examination.
CMS billing rules for 88307
- 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 RVU1.55 · 19%
- Practice expense (office) RVU6.70 · 81%
- Malpractice RVU0.07 · 1%
904K
Medicare services in 2024 · #154 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.
88307 compared with similar codes
Office rates for Ohio, from the same CMS release.
88309 is Level VI and includes colon segmental resection for tumor. Select 88307 or 88309 from the specific specimen classification, rather than tumor diagnosis alone.
88331 reports an intraoperative frozen-section consultation; 88307 reports the final gross and microscopic examination. Both may be reported for the same specimen.
88321 is a consultation on slides prepared elsewhere; 88307 covers the gross and microscopic examination of a submitted tissue specimen.
Compare 88307 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
Ohio →
Office / nonfacility
$258.44
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 88307 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
11,209
- Code
- 88307
- Physician work
- 1.55
- Practice expense
- 6.70
- Malpractice
- 0.07
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.55 | × 1.000 | 1.5500 |
| Practice expense | 6.70 | × 0.913 | 6.1171 |
| Malpractice | 0.07 | × 1.008 | 0.0706 |
| Total RVUs | 7.7377 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$258.44
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.55 | 1 |
| Practice expense | 6.7 | 0.913 |
| Malpractice | 0.07 | 1.008 |
(1.55 × 1 + 6.7 × 0.913 + 0.07 × 1.008) × $33.4009 = $258.44
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.
88307 billing questions
How is 88307 chosen over 88305 or 88309?
Choose the level assigned to the specimen type in CPT, not by slide count or time. A prostate needle biopsy is Level IV (88305); a colon segmental resection for tumor is Level VI (88309).
How many units are reported when multiple specimens are submitted?
Report one unit per distinct, separately identified specimen assigned to Level V. Two such specimens from the same case yield two units; multiple fragments of one specimen do not.
When is modifier 26 or TC used?
Use 26 when billing only the pathologist's interpretation and report. Use TC for the laboratory's technical work; bill without a modifier when one entity provides both components.
Are routine H&E stains billed separately?
No. Routine hematoxylin and eosin staining is included. Special stains, such as 88312 or 88313, and immunohistochemistry, such as 88342, may be separately reported when indicated and documented.
Can a frozen section be billed with 88307 on the same specimen?
Yes. An intraoperative frozen-section consultation (88331, with 88332 for each additional tissue block) may be reported with the final 88307 examination of that specimen.
Is decalcification included?
Decalcification is separately reported with 88311 when performed in addition to the surgical pathology examination, such as for bone or calcified tissue.
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.
