Billing code 88355: Muscle analysisMedicare rate & RVUs in Virginia
Reports quantitative morphometric measurement of skeletal muscle biopsy tissue, typically when evaluating suspected myopathic or neurogenic disease beyond routine histologic examination.
Medicare pays $138.64–$157.73 for 88355 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 88355 covers
A pathology laboratory performs quantitative morphometric assessment of skeletal muscle tissue, commonly from a biopsy obtained during evaluation of suspected myopathy, muscular dystrophy, or neurogenic muscle change. The analysis measures histologic muscle-fiber features; a pathologist interprets the findings in the context of the tissue and clinical question. It may be performed in a hospital laboratory or an independent pathology laboratory.
Report 88355 when skeletal muscle morphometric analysis is performed in addition to routine tissue examination, not for routine microscopic review alone. The report should identify the specimen and document the quantitative analysis and findings. CMS recognizes a professional component for interpretation and a technical component for the equipment and staff performing the test. Report modifier 26 for the professional component, modifier TC for the technical component, or neither modifier for 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 88355 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $157.73 | Unavailable |
| Virginia | $138.64 | Unavailable |
How the 88355 rate is calculated
Each of 88355’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 · 88355
RVUs × geographic indexes × conversion factor
Work1.80
1.80 RVUs× 1.000 GPCI
Practice expense2.37
2.37 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
4.2000
Conversion factor
$33.4009
Medicare rate
$140.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 88355
The CMS indicators that decide how 88355 is paid alongside other services.
CMS payment indicators · 88355
Muscle analysis
| 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
88355 without 26 · national office
$140.28
Muscle analysis
88355-26 · Professional component
$78.49
Pays only the interpretation and report.
88355 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 88305Tissue pathology exam
- 88305 covers routine surgical pathology examination of a specimen. 88355 applies when quantitative morphometric analysis of skeletal muscle is also performed.
- 88356Nerve analysis
- 88356 is for morphometric analysis of nerve tissue; 88355 is for skeletal muscle tissue.
- 88358Tumor analysis
- 88358 addresses morphometric analysis of tumor tissue, while 88355 addresses skeletal muscle.
88355 billing questions
How is 88355 different from routine muscle biopsy pathology?
Routine microscopic examination evaluates the biopsy for diagnosis. 88355 represents additional quantitative morphometric analysis of skeletal muscle tissue, so the record should support that distinct analysis.
When should 88355 be chosen instead of 88356?
Use 88355 for morphometric analysis of skeletal muscle. 88356 is the related analysis code for nerve tissue.
Can 88355 be reported with the muscle biopsy pathology code?
Both may be reported when the muscle biopsy receives routine surgical pathology examination and a separately performed morphometric analysis. The documentation should show both services.
Which modifiers identify the components?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.
What documentation supports 88355?
Document the skeletal muscle specimen, the quantitative morphometric work performed, the findings, and the pathologist's interpretation.
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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