CPT 88323Laboratory

Consltj&reprt matrl prep sld

CPT code 88323 is used when a pathologist reviews slides that were prepared at another facility and provides a consultation report. This is common when a second opinion is needed on tissue samples or when specialized expertise is required.

Showing rates for

National Average

Base Medicare rate

$112.57

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

1.83

PE RVU (NF)

1.62

MP RVU

0.03

Total RVU

3.48

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Document the medical necessity for preparing new slides rather than reviewing existing slides (which would be 88321)
Impact: Prevents downcoding from 88323 ($112.57) to 88321 (lower rate); saves approximately $30-40 per claim
Verify that referred material actually requires slide preparation; if reviewing already-prepared slides only, use 88321 instead
Impact: Ensures accurate coding and prevents audit findings with potential recoupment of overpayments
Maintain detailed records of materials received including condition, type (blocks vs. slides), and number of slides prepared
Impact: Supports medical necessity during audits and appeals; reduces denial rate by 15-25%
Bill only once per consultation episode regardless of number of slides prepared from referred material
Impact: Prevents bundling denials and duplicate payment recoveries; 88323 is per consultation not per slide
Include the original pathology report and reason for consultation request in documentation
Impact: Demonstrates medical necessity and supports higher-level consultation codes; improves first-pass payment rate by 20%
Consider modifier 26 if your facility receives pre-cut slides but performs additional slide preparation
Impact: Ensures proper component billing; prevents $30-45 underpayment when technical work is split between facilities

Common denials

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 88323?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the difference between CPT 88323 and 88321?

CPT 88323 includes preparation of slides from referred material (tissue blocks, paraffin blocks) plus consultation, while 88321 is for consultation on slides already prepared by the referring facility. If you receive blocks and must cut new slides, use 88323. If you receive ready-to-review slides only, use 88321.

How much does Medicare pay for CPT 88323 in 2025?

The 2025 Medicare national average payment for CPT 88323 is $112.57 for both facility and non-facility settings. The code has 3.48 total RVUs (1.83 work RVU, 1.62 PE RVU, 0.03 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can I bill 88323 multiple times for the same patient?

You can bill 88323 only once per consultation episode, regardless of how many slides you prepare from the referred material. If multiple separate consultations are requested on different specimens or at different times, each can be billed separately with appropriate documentation of distinct clinical questions.

Does CPT 88323 include special stains or immunohistochemistry?

No, CPT 88323 covers only routine slide preparation and consultation. Special stains (88312-88314, 88319) and immunohistochemistry (88342-88343) are billed separately when medically necessary and documented. These ancillary studies support the consultation but are not bundled into 88323.

Who can bill CPT 88323 - only pathologists?

CPT 88323 must be billed under the supervision of a board-certified pathologist. While histotechnologists may perform the technical slide preparation component, the professional interpretation and consultation report must be completed and signed by a qualified pathologist with appropriate credentials and licensure.

What documentation proves medical necessity for CPT 88323?

Medical necessity requires: written consultation request from referring physician stating the clinical question, the original pathology report, documentation that new slides needed to be prepared (not just reviewing existing slides), evidence of specialized expertise required, and a detailed written consultation report addressing the specific clinical question.

Can CPT 88323 be billed with modifier 26 for professional component only?

Yes, modifier 26 can be appended when your pathologist provides only the professional interpretation while another entity performs the technical slide preparation. Conversely, use modifier TC if you only perform the technical component while another pathologist provides the interpretation. Without modifiers, 88323 represents the global service including both components.