How much does Medicare pay for CPT 88313?

Medicare allowed an average of $43.56 per service and paid $34.59 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $130.06, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 88313?

Special stained specimen slides to examine tissue including interpretation and report. It was billed 1,394,911 times to 619,720 Medicare beneficiaries by 6,734 providers in 2024.

Does 88313 pay differently in an office than a hospital?

Yes. The allowed amount averaged $63.24 in an office setting and $12.68 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 88313 most?

Pathology, with 973,458 services from 5,740 clinicians. Next are Clinical Laboratory, Gastroenterology, Dermatology.

CPT 88313

Special stained specimen slides to examine tissue including interpretation and report

$43.56Medicare-allowed amount per service, averaged across 1,394,911 services

Providers submitted

$130.06

Asking price, not received

Medicare allowed

$43.56

The fee schedule figure

Medicare paid

$34.59

Balance is patient coinsurance

Providers submitted an average of $130.06 for this code and Medicare allowed $43.56 — 3.0× 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 $34.59 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $63.24
Hospital / facility: $12.68

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. 851,964 services were billed in an office setting and 542,947 in a facility.

Services: 1,394,911
Beneficiaries: 619,720
Providers billing it: 6,734
Total allowed: $60,762,323

What Medicare pays for CPT 88313

Across 1,394,911 services billed by 6,734 providers to 619,720 beneficiaries, Medicare allowed an average of $43.56 per service. That is 2.3 services per beneficiary, so this is a code patients typically receive more than once. 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 88313

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	973,458	438,291	$36.98	5,740
Clinical Laboratory	309,376	134,752	$58.97	321
Gastroenterology	69,103	27,643	$56.97	354
Dermatology	16,420	7,169	$71.77	173
Podiatry	9,813	3,664	$80.81	20
Urology	5,551	2,989	$38.86	26
Internal Medicine	5,217	2,142	$49.49	34
Ophthalmology	1,869	1,390	$17.61	18
Hematology	1,308	371	$11.90	7
Clinical Cardiac Electrophysiology	708	186	$12.93	1
Neurology	466	110	$11.73	6
Hematology-Oncology	395	364	$48.75	14
Anesthesiology	376	130	$53.44	2
General Practice	238	93	$17.00	3
Slide Preparation Facility	182	145	$69.71	3

88313 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	153,825	$46.96	$32.98	654
New York	134,798	$51.50	$35.34	479
Florida	122,722	$50.04	$40.90	482
Texas	104,844	$44.46	$35.87	553
New Jersey	103,970	$65.17	$45.82	190
Arkansas	92,967	$25.48	$22.78	101
Maryland	77,453	$69.55	$47.67	141
Pennsylvania	56,175	$38.00	$29.15	294
Georgia	52,905	$47.64	$38.68	198
Tennessee	42,922	$40.92	$35.29	200
Arizona	42,396	$47.44	$38.87	163
Illinois	38,799	$38.54	$30.21	280
Massachusetts	35,308	$29.43	$21.11	279
Virginia	31,758	$26.52	$20.45	151
Ohio	29,228	$28.26	$23.78	236
South Carolina	25,605	$45.87	$40.12	109
Connecticut	23,793	$59.81	$43.68	109
Missouri	18,316	$23.72	$19.89	152
North Carolina	18,148	$31.02	$25.98	177
Minnesota	16,531	$23.70	$17.28	148
Louisiana	13,868	$36.72	$32.83	87
Washington	13,565	$27.57	$20.85	146
Indiana	12,983	$22.51	$18.59	102
Wisconsin	12,636	$24.03	$19.26	139
Oklahoma	12,447	$28.25	$26.68	52
Alabama	11,220	$30.96	$27.11	84
Michigan	9,970	$14.49	$11.44	144
Colorado	9,870	$34.83	$27.06	91
Kansas	7,642	$22.29	$18.41	55
Mississippi	7,126	$34.14	$28.23	45
Utah	6,059	$36.38	$29.46	51
Delaware	5,931	$31.60	$26.50	28
Iowa	5,898	$23.22	$19.51	85
Kentucky	5,179	$21.40	$17.03	78
Oregon	4,281	$30.32	$23.77	68
District of Columbia	3,739	$23.26	$17.04	24
Nebraska	3,490	$17.77	$14.96	47
Nevada	3,245	$29.67	$23.73	32
New Mexico	2,930	$40.21	$34.35	28
New Hampshire	2,725	$17.03	$13.27	37
West Virginia	2,677	$27.51	$25.41	34
Maine	2,438	$16.34	$13.42	28
Rhode Island	2,346	$40.84	$30.23	25
South Dakota	1,896	$12.33	$9.93	13
North Dakota	1,678	$13.49	$10.58	23
Montana	1,402	$16.96	$13.53	17
Idaho	1,376	$20.17	$17.28	14
Vermont	1,247	$11.26	$8.99	25
Hawaii	1,193	$25.62	$18.35	18
Alaska	802	$15.48	$8.93	10
Wyoming	358	$11.76	$9.95	2
Puerto Rico	203	$33.35	$26.52	5
AP	28	$11.65	$9.12	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
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
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.