CPT 88305: Surgical Pathology, Level IV (Tissue Exam)

What is CPT 88305 used for?

CPT 88305 reports a Level IV surgical pathology examination of a single tissue specimen, including both gross (naked-eye) and microscopic evaluation by a pathologist. It is the most commonly reported surgical pathology code, covering routine specimens such as skin biopsies, breast biopsies, GI biopsies, and many others assigned to the Level IV list.

Unlike the clinical lab panels priced on the CLFS, surgical pathology carries a physician interpretation, which is why it behaves like a physician service on the fee schedule.

How much does 88305 pay in 2026?

Here is the key difference from lab panels: 88305 is on the Physician Fee Schedule. In 2026 the national global allowed amount is about $70.14, with a global period of XXX. Run your locality-adjusted figure through the Medicare fee calculator.

When do you use modifier 26 or TC?

Because 88305 has both a professional and a technical piece, the modifier depends on who performed what:

• Pathologist interprets, but an outside/hospital lab did the processing → bill with modifier 26 for the professional component only.
• Your lab did the technical processing but not the read → bill with modifier TC.
• You performed both the technical work and the interpretation → bill globally with no modifier.

Example: a pathology group reads a hospital's slides but the hospital owns the lab. The group bills 88305-26 (~$35) and the hospital bills 88305-TC (~$35); together they equal the ~$70.14 global.

How is 88305 counted and edited?

Units are counted per specimen, not per block or slide. A specimen is a separately identified tissue receiving its own diagnosis.

Coverage follows payer medical-necessity policy, and the paid allowed amount depends on the 26/TC split and locality. Confirm the specimen count on the requisition matches the units billed.