Billing code 80506: Pathology consultationMedicare rate & RVUs in Oregon
Report 80506 for additional time spent by a clinical pathologist on a prolonged consultation after the initial high-level consultation service.
Medicare pays $41.20–$43.23 for 80506 in the office in Oregon, from Rest Of Oregon to Portland. 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 80506 covers
A clinical pathologist uses this add-on for extended consultation with a treating clinician about laboratory findings, test selection, or interpretation. The work may involve reviewing current and prior results, relevant diagnostic studies, and clinical information, then discussing how the findings inform patient care. These consultations commonly occur between laboratory-based pathologists and clinicians managing patients in hospital or outpatient settings.
Report 80506 with the primary high-level consultation code 80505, not as a stand-alone service. Documentation should support the consultation work, time, records or results reviewed, and communication with the treating clinician. CMS classifies the service as an add-on paid within the primary procedure’s global period. The service has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and an unmodified claim 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.
Where 80506 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $43.23 | Unavailable |
| Rest Of Oregon | $41.20 | Unavailable |
How the 80506 rate is calculated
Each of 80506’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 · 80506
RVUs × geographic indexes × conversion factor
Work0.80
0.80 RVUs× 1.000 GPCI
Practice expense0.40
0.40 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
1.2500
Conversion factor
$33.4009
Medicare rate
$41.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 80506
The CMS indicators that decide how 80506 is paid alongside other services.
CMS payment indicators · 80506
Pathology consultation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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. |
80506 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 80503Pathology consultation
- 80503 represents a limited consultation. 80506 is an add-on for prolonged time and must accompany its primary service.
- 80504Pathology consult
- 80504 represents a moderate consultation. Use 80506 only for prolonged time beyond the primary high-level service.
- 80505Clinical pathology consult
- 80505 reports the primary high-level consultation; 80506 is the add-on for prolonged consultation time and cannot replace it.
80506 billing questions
When should 80506 be reported instead of 80505?
Use 80505 for the initial high-level clinical pathology consultation. Report 80506 for qualifying prolonged consultation time as an add-on to that primary service.
Can 80506 be billed by itself?
No. It is an add-on code and must be reported with its primary service, 80505.
What documentation supports 80506?
Record the consultation work and time, the laboratory results or other diagnostic information reviewed, and the discussion or recommendations communicated to the treating clinician.
How do modifiers 26 and TC relate to this code?
Modifier 26 identifies the professional interpretation, while TC identifies the technical portion involving equipment and staff. Billing without a modifier represents the global service.
How many units of 80506 should be reported?
Report units based on the prolonged consultation time supported in the record and the code’s additional-time increment. Do not use 80506 to represent the initial consultation.
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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