Billing code 88309: Tissue pathologyMedicare rate & RVUs in Texas
Reports gross and microscopic examination of designated Level VI radical resection specimens, commonly including major oncologic resections such as radical hysterectomy.
Medicare pays $384.56–$431.81 for 88309 in the office in Texas, from Beaumont to Austin. 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 88309 covers
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.
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 88309 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$384.56 to $431.81
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $431.81 | Unavailable |
| Beaumont | $384.56 | Unavailable |
| Brazoria | $410.63 | Unavailable |
| Dallas | $412.57 | Unavailable |
| Fort Worth | $409.43 | Unavailable |
| Galveston | $411.43 | Unavailable |
| Houston | $413.26 | Unavailable |
| Rest Of Texas | $396.91 | Unavailable |
How the 88309 rate is calculated
Each of 88309’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 · 88309
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.73Practice expense 9.55Malpractice 0.10
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 88309
The CMS indicators that decide how 88309 is paid alongside other services.
CMS payment indicators · 88309
Tissue pathology
| 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
88309 without 26 · national office
$413.50
Tissue pathology
88309-26 · Professional component
$134.61
Pays only the interpretation and report.
88309 compared with similar codes
Compare codes
88309 vs 88307 vs 88305 vs 88300: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 88307Tissue pathology exam
- 88307 applies to specimen types designated Level V. 88309 applies to Level VI specimens, including radical hysterectomy and radical prostatectomy specimens.
- 88305Tissue pathology exam
- 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.
- 88300Gross pathology
- 88300 covers gross examination only. 88309 represents a Level VI examination that includes gross and microscopic work.
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 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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