CPT 88302Laboratory

Tissue exam by pathologist

CPT 88302 covers the pathologist's examination of simple tissue specimens like skin tags, tooth fragments, or tissue from foreskin circumcision. This is the most basic level of pathology tissue examination requiring minimal microscopic evaluation.

Showing rates for

National Average

Base Medicare rate

$32.35

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.13

PE RVU (NF)

0.85

MP RVU

0.02

Total RVU

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify specimen type matches the CPT-defined list for 88302 before coding; many specimens that seem simple actually qualify for 88304 or higher levels
Impact: Undercoding 88304 ($50.36) as 88302 results in $18.01 loss per specimen; with high-volume practices processing 100+ specimens monthly, this equals $21,612+ annual revenue loss
Bill units based on number of specimens submitted in separate containers, not number of tissue fragments within one container
Impact: Proper unit reporting: two separately-submitted foreskin specimens = 2 units of 88302 ($64.70) not 1 unit ($32.35); improves revenue by 100% for multi-specimen cases
Ensure requisition clearly identifies specimen type using CPT-compliant terminology (e.g., 'foreskin, newborn' not 'circumcision tissue')
Impact: Reduces denial rate by 15-25%; vague specimen descriptions trigger payer audits and downcoding to 88300 or denial for lack of medical necessity
Do not bill 88302 for specimens that are merely 'observed' or examined grossly only without microscopic review; use 88300 for gross-only examination
Impact: Overcoding 88300 ($20.71) as 88302 increases audit risk and potential recoupment demands; proper coding prevents compliance issues
When pathologist performs additional services like immunohistochemistry or special stains, bill these separately with appropriate add-on codes (88342, 88360, etc.)
Impact: Ancillary testing adds $75-$300+ per specimen; failing to capture these separately-billable services represents 70-85% revenue leakage in surgical pathology
Maintain specimen tracking logs correlating surgical orders, pathology requisitions, and final reports to support medical necessity during audits

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 88302 in 2025?

The 2025 Medicare national average payment for CPT 88302 is $32.35 for both facility and non-facility settings. This rate is based on 1.0 total RVUs (0.13 work RVU, 0.85 PE RVU, 0.02 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

What specimens qualify for CPT code 88302?

CPT 88302 is limited to a specific list including: appendix incidental, fallopian tube sterilization, fingers/toes amputation traumatic, foreskin newborn, hernia sac, hydrocele sac, nerve, skin plastic repair, sympathetic ganglion, testis castration, vaginal mucosa incidental, vas deferens sterilization, and tooth. Any specimen not on this list requires a different pathology code (typically 88304 or higher).

Can I bill multiple units of 88302 for the same patient on the same day?

Yes, you can bill multiple units of 88302 when multiple qualifying specimens are submitted in separate, individually-labeled containers from different anatomic sites or distinct sources. Each separately-submitted specimen earns separate reimbursement. However, multiple fragments from the same source in one container count as one unit only.

What is the difference between CPT 88300 and 88302?

CPT 88300 ($20.71) covers gross examination only without microscopic review, while CPT 88302 ($32.35) includes both gross and microscopic examination. If the pathologist only visually inspects the specimen without preparing slides or performing microscopic evaluation, use 88300. If any microscopic review occurs for a qualifying specimen, use 88302.

Do I need a modifier when billing 88302 with a surgical procedure?

Generally no modifier is needed as pathology services are separately billable from surgical procedures. However, verify NCCI edits for the specific surgical CPT code. If bundling edits exist, modifier 59 may be required to demonstrate the pathology service is distinct and separately identifiable. Check with the specific payer's billing guidelines.

How many RVUs is CPT code 88302 worth in 2025?

CPT 88302 has a total of 1.0 RVUs in 2025, consisting of 0.13 work RVUs, 0.85 practice expense RVUs (both facility and non-facility), and 0.02 malpractice RVUs. This represents the lowest RVU value in the surgical pathology code family, reflecting the minimal complexity of Level I specimens.

What documentation do I need to support billing CPT 88302?

Required documentation includes a signed pathology report by a qualified pathologist with specimen identification, gross description, microscopic findings (even if minimal), final diagnosis, accession number, and dates of service. The specimen type must clearly match the CPT-defined list for 88302, and clinical indication should support medical necessity for the examination.