How much does Medicare pay for CPT 88304?

Medicare allowed an average of $21.25 per service and paid $16.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $111.14, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 88304?

Pathology examination of tissue using a microscope, moderately low complexity. It was billed 773,344 times to 674,872 Medicare beneficiaries by 8,727 providers in 2024.

Does 88304 pay differently in an office than a hospital?

Yes. The allowed amount averaged $35.06 in an office setting and $11.07 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 88304 most?

Pathology, with 549,641 services from 7,518 clinicians. Next are Clinical Laboratory, Dermatology, Ophthalmology.

CPT 88304

Pathology examination of tissue using a microscope, moderately low complexity

$21.25Medicare-allowed amount per service, averaged across 773,344 services

Providers submitted

$111.14

Asking price, not received

Medicare allowed

$21.25

The fee schedule figure

Medicare paid

$16.25

Balance is patient coinsurance

Providers submitted an average of $111.14 for this code and Medicare allowed $21.25 — 5.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $16.25 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $35.06
Hospital / facility: $11.07

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 328,091 services were billed in an office setting and 445,253 in a facility.

Services: 773,344
Beneficiaries: 674,872
Providers billing it: 8,727
Total allowed: $16,433,560

What Medicare pays for CPT 88304

Across 773,344 services billed by 8,727 providers to 674,872 beneficiaries, Medicare allowed an average of $21.25 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 88304

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	549,641	489,954	$16.37	7,518
Clinical Laboratory	157,478	128,577	$34.12	337
Dermatology	58,852	50,888	$31.87	788
Ophthalmology	2,832	2,222	$14.18	27
Podiatry	1,855	847	$41.47	7
Micrographic Dermatologic Surgery	718	630	$35.58	15
Diagnostic Radiology	504	433	$11.50	5
Oral Surgery (Dentist only)	264	259	$39.16	7
General Practice	235	214	$13.41	3
Family Practice	234	212	$33.25	4
Undefined Physician type	232	202	$12.78	1
Gastroenterology	89	76	$33.02	1
Oral and Maxillofacial Pathology	67	58	$32.07	2
Pain Management	63	58	$11.85	1
Dentist	62	62	$10.79	2

88304 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	74,139	$24.22	$16.23	818
Florida	68,954	$24.16	$18.59	547
Texas	66,928	$24.02	$18.43	693
New York	50,806	$26.17	$17.58	534
Pennsylvania	34,795	$18.83	$14.26	418
Massachusetts	30,441	$20.19	$14.01	340
Illinois	28,864	$16.41	$12.34	388
Ohio	27,788	$18.48	$14.89	347
Arkansas	22,262	$30.49	$25.93	88
Tennessee	21,548	$20.15	$16.54	216
New Jersey	21,044	$18.10	$12.70	194
North Carolina	20,634	$21.11	$16.86	235
Georgia	20,148	$26.02	$19.64	219
Maryland	17,013	$20.27	$14.32	183
Wisconsin	16,770	$21.96	$17.05	194
Arizona	15,721	$24.80	$18.50	180
Michigan	15,147	$16.22	$12.53	281
Washington	14,755	$23.56	$16.45	206
Virginia	14,552	$18.26	$13.90	171
South Carolina	14,380	$17.38	$14.13	144
Missouri	13,061	$16.53	$13.18	182
Alabama	12,524	$22.78	$18.77	115
Indiana	12,275	$15.99	$13.00	171
Louisiana	11,896	$14.50	$11.94	116
Minnesota	9,695	$15.48	$11.84	214
Colorado	9,593	$19.71	$14.48	139
Kansas	9,217	$17.14	$13.92	94
Kentucky	8,556	$15.24	$12.39	126
Iowa	8,318	$14.93	$12.12	99
Oklahoma	7,719	$18.33	$15.04	67
Connecticut	7,588	$23.69	$16.94	110
Mississippi	7,068	$14.95	$12.61	64
Nebraska	6,337	$14.29	$11.39	73
Oregon	5,936	$20.10	$14.96	110
Nevada	4,866	$21.54	$16.86	57
New Hampshire	4,330	$21.24	$15.87	51
Utah	3,742	$18.68	$14.84	84
West Virginia	3,630	$15.89	$12.52	62
South Dakota	3,239	$13.71	$10.59	40
New Mexico	3,119	$16.51	$13.08	44
North Dakota	3,012	$13.48	$10.24	31
Maine	2,852	$13.79	$10.24	41
Delaware	2,778	$21.66	$16.81	28
Montana	2,543	$15.70	$12.04	28
Hawaii	2,489	$27.58	$18.83	25
Idaho	1,997	$21.75	$18.00	25
Rhode Island	1,948	$11.40	$8.67	37
District of Columbia	1,747	$13.08	$9.50	24
Vermont	1,384	$12.07	$9.10	26
Puerto Rico	1,296	$30.94	$22.71	22
Alaska	1,118	$15.73	$10.11	14
Wyoming	549	$27.76	$20.51	8
Guam	78	$11.54	$8.56	1
AP	74	$24.16	$17.46	1
ZZ	57	$10.54	$7.90	1
AE	24	$11.88	$8.59	1

Related codes

88305Pathology examination of tissue$50.75
88341Special stained specimen slides to examine tissue$40.33
88342Special stained specimen slides to examine tissue$58.61
88313Special stained specimen slides to examine tissue including interpreta$43.56
88312Special stained specimen slides to identify organisms including interp$75.82
88307Pathology examination of tissue$84.93
88360Microscopic genetic analysis of tumor$59.67
88311Preparation of tissue for examination by removing any calcium present$12.68
88331Pathology examination of specimen during surgery$72.30
88350Antibody evaluation$59.99
88344Special stained specimen slides to examine tissue$100.56
88374Microscopic genetic analysis of tissue$108.04

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.