How much does Medicare pay for CPT 88323?

Medicare allowed an average of $98.64 per service and paid $77.39 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $284.13, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 88323?

Surgical pathology consultation and report on referred material requiring preparation of slides. It was billed 24,698 times to 23,057 Medicare beneficiaries by 442 providers in 2024.

Does 88323 pay differently in an office than a hospital?

Yes. The allowed amount averaged $100.86 in an office setting and $88.19 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 88323 most?

Pathology, with 10,609 services from 331 clinicians. Next are Clinical Laboratory, Dermatology, Undefined Physician type.

CPT 88323

Surgical pathology consultation and report on referred material requiring preparation of slides

$98.64Medicare-allowed amount per service, averaged across 24,698 services

Providers submitted

$284.13

Asking price, not received

Medicare allowed

$98.64

The fee schedule figure

Medicare paid

$77.39

Balance is patient coinsurance

Providers submitted an average of $284.13 for this code and Medicare allowed $98.64 — 2.9× 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 $77.39 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $100.86
Hospital / facility: $88.19

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. 20,376 services were billed in an office setting and 4,322 in a facility.

Services: 24,698
Beneficiaries: 23,057
Providers billing it: 442
Total allowed: $2,436,211

What Medicare pays for CPT 88323

Across 24,698 services billed by 442 providers to 23,057 beneficiaries, Medicare allowed an average of $98.64 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 88323

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pathology	10,609	10,135	$97.24	331
Clinical Laboratory	10,374	9,637	$98.28	71
Dermatology	3,685	3,255	$103.69	39
Undefined Physician type	30	30	$99.58	1

88323 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	9,282	$106.38	$74.68	103
Florida	1,813	$100.43	$81.04	20
Ohio	1,761	$74.65	$61.45	34
Texas	1,071	$96.89	$74.88	24
Minnesota	955	$92.54	$73.40	8
Iowa	913	$85.14	$68.42	22
Maryland	824	$109.51	$82.91	8
Washington	732	$98.44	$70.73	16
Arizona	676	$106.20	$85.01	12
Georgia	614	$113.36	$79.61	9
New York	477	$103.75	$73.78	18
Pennsylvania	422	$87.93	$69.28	13
Oregon	418	$101.51	$75.69	11
Massachusetts	408	$91.81	$63.99	8
Illinois	399	$106.58	$81.95	15
Tennessee	387	$79.82	$64.59	5
Virginia	372	$92.10	$71.94	12
Colorado	372	$92.95	$71.57	9
New Jersey	334	$92.12	$69.41	8
Indiana	288	$100.76	$80.58	8
Kentucky	247	$94.50	$77.76	6
Nebraska	235	$80.18	$64.00	9
Connecticut	230	$81.48	$60.98	3
Kansas	220	$72.24	$58.53	7
Missouri	191	$100.43	$81.40	6
North Carolina	163	$101.30	$80.76	8
Utah	136	$93.34	$74.85	6
Michigan	128	$93.78	$70.22	7
South Dakota	126	$78.57	$61.37	4
Arkansas	106	$98.26	$81.84	4
South Carolina	106	$80.01	$63.55	6
Wisconsin	89	$98.11	$71.97	4
New Mexico	69	$92.46	$76.76	1
Alabama	54	$83.13	$66.62	3
Hawaii	21	$126.65	$85.60	1
Delaware	20	$105.18	$80.52	1
ZZ	13	$85.48	$65.05	1
District of Columbia	13	$97.52	$66.55	1
Louisiana	13	$33.63	$35.12	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
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.