How much does Medicare pay for CPT 88309?

Medicare allowed an average of $143.22 per service and paid $113.54 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $555.98, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 88309?

Pathology examination of tissue using a microscope, high complexity. It was billed 103,742 times to 93,576 Medicare beneficiaries by 3,913 providers in 2024.

Does 88309 pay differently in an office than a hospital?

Yes. The allowed amount averaged $250.20 in an office setting and $139.27 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 88309 most?

Pathology, with 99,257 services from 3,858 clinicians. Next are Clinical Laboratory, Dermatology, Hematology-Oncology.

CPT 88309

Pathology examination of tissue using a microscope, high complexity

$143.22Medicare-allowed amount per service, averaged across 103,742 services

Providers submitted

$555.98

Asking price, not received

Medicare allowed

$143.22

The fee schedule figure

Medicare paid

$113.54

Balance is patient coinsurance

Providers submitted an average of $555.98 for this code and Medicare allowed $143.22 — 3.9× 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 $113.54 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $250.20
Hospital / facility: $139.27

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. 3,696 services were billed in an office setting and 100,046 in a facility.

Services: 103,742
Beneficiaries: 93,576
Providers billing it: 3,913
Total allowed: $14,857,929

What Medicare pays for CPT 88309

Across 103,742 services billed by 3,913 providers to 93,576 beneficiaries, Medicare allowed an average of $143.22 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 88309

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	99,257	89,803	$139.48	3,858
Clinical Laboratory	3,993	3,416	$228.27	43
Dermatology	315	198	$223.42	5
Hematology-Oncology	47	36	$133.62	1
General Practice	30	30	$136.58	1
Diagnostic Radiology	27	27	$131.62	1
Gastroenterology	24	23	$452.62	1
Oral and Maxillofacial Pathology	18	15	$133.04	1
Pain Management	16	16	$149.57	1
Dentist	15	12	$139.79	1

88309 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	10,217	$153.78	$110.32	355
New York	6,865	$151.70	$110.48	235
Florida	6,698	$136.72	$108.46	235
Texas	6,539	$136.16	$107.94	273
Pennsylvania	5,255	$138.13	$108.20	188
Massachusetts	4,360	$145.78	$108.32	156
Illinois	3,997	$139.52	$108.32	171
Ohio	3,605	$133.01	$108.12	162
Missouri	3,555	$232.88	$189.42	97
Tennessee	3,398	$132.30	$108.41	117
Maryland	3,303	$143.25	$107.96	111
Virginia	2,841	$136.84	$108.08	99
Washington	2,583	$144.50	$108.73	97
Arizona	2,577	$135.46	$108.37	98
North Carolina	2,541	$133.83	$108.35	103
Georgia	2,272	$135.58	$108.20	92
New Jersey	2,223	$146.55	$107.77	96
South Carolina	2,166	$132.70	$108.62	72
Minnesota	2,119	$139.14	$108.24	84
Indiana	2,021	$133.99	$110.26	77
Michigan	1,985	$135.00	$107.85	101
Wisconsin	1,712	$135.04	$107.73	67
Kentucky	1,602	$133.28	$108.11	71
Kansas	1,566	$133.45	$108.50	54
Iowa	1,533	$134.34	$108.38	58
Alabama	1,318	$131.61	$108.21	51
Oklahoma	1,276	$132.00	$107.93	42
Colorado	1,267	$139.46	$108.62	53
Louisiana	1,242	$132.58	$108.27	49
Arkansas	1,142	$131.76	$108.67	44
Oregon	1,023	$140.51	$107.92	47
Mississippi	975	$132.24	$107.46	34
Nebraska	957	$133.17	$108.25	37
Utah	744	$135.66	$107.27	32
West Virginia	666	$134.03	$107.91	30
South Dakota	585	$135.54	$107.48	17
Connecticut	572	$142.13	$107.74	32
Montana	533	$134.48	$108.13	16
New Mexico	531	$172.25	$142.28	14
New Hampshire	505	$138.05	$108.01	20
Nevada	387	$135.91	$108.48	17
Delaware	371	$137.10	$108.49	12
Maine	340	$135.89	$107.33	15
District of Columbia	335	$151.32	$108.61	15
North Dakota	255	$136.10	$107.49	10
Rhode Island	227	$141.04	$107.40	15
Idaho	225	$132.58	$108.81	11
Hawaii	219	$145.01	$108.57	9
Alaska	196	$177.18	$108.12	8
Vermont	156	$135.29	$104.77	7
ZZ	100	$138.03	$105.59	4
Puerto Rico	41	$136.91	$98.92	2
Guam	21	$148.11	$108.66	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
88304Pathology examination of tissue$21.25
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

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.