88300

Pathology examination of tissue using a microscope, limited examination

Medicare pricing data for 9,735 providers across 52 states

🤖AI Overview

This procedure has a 8.9x markup — hospitals charge $44.60 but Medicare allows only $5.00. Uninsured patients may face bills 8.9 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Pathology examination of tissue using a microscope, limited examination (HCPCS code 88300) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $5.00, but hospitals typically charge $44.60 — a 8.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$1.00

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $5.00, your out-of-pocket cost would be approximately $1.00. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$5.00
Average Hospital Charge
$44.60
Markup Ratio
8.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$44.60
Medicare Allowed$5.00
Medicare Payment$3.90

Hospitals charge 8.9x more than what Medicare allows for this procedure. Medicare actually pays $3.90 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Puerto Rico$7$1246138+37.4%
New Jersey$6$472455,656+17.8%
Oregon$6$2394612+14.6%
New York$6$3970913,964+12.8%
Nevada$5$54671,075+8.6%
Hawaii$5$2443460+7.2%
California$5$391,03324,230+7.0%
Arizona$5$311902,418+5.8%
Georgia$5$382011,874+5.4%
Texas$5$5879212,030+5.2%
Maryland$5$362052,932+5.0%
Alaska$5$7314184+4.8%
Florida$5$5963216,103+2.6%
Massachusetts$5$433697,130+2.4%
New Hampshire$5$11643594+0.8%
Colorado$5$401421,872+0.4%
Connecticut$5$421612,308+0.4%
Wyoming$5$55853-1.6%
Virginia$5$411852,336-2.2%
District of Columbia$5$3241428-2.4%
Washington$5$362061,191-2.6%
Tennessee$5$342593,565-2.8%
Kansas$5$481071,136-3.6%
Utah$5$4262406-4.0%
Louisiana$5$371502,018-4.4%
Illinois$5$554316,639-6.0%
Pennsylvania$5$374649,736-6.8%
Mississippi$5$46791,303-7.0%
Nebraska$5$3168700-8.4%
Michigan$5$503024,812-9.0%
Oklahoma$5$32821,244-9.0%
Rhode Island$5$4941281-9.2%
Alabama$5$361181,677-9.4%
North Dakota$5$3231452-10.0%
New Mexico$4$4441480-10.2%
Maine$4$1942225-10.8%
Arkansas$4$27781,362-11.0%
North Carolina$4$432322,636-11.4%
Missouri$4$411993,319-11.6%
Delaware$4$5525693-11.8%
Indiana$4$521664,825-12.0%
Ohio$4$494126,129-12.6%
Montana$4$2221644-13.2%
Kentucky$4$371293,020-13.6%
Wisconsin$4$621651,293-13.6%
South Carolina$4$481312,015-14.2%
Minnesota$4$302341,709-14.6%
Vermont$4$2122159-15.0%
West Virginia$4$3557761-15.6%
South Dakota$4$4435230-16.8%
Iowa$4$38862,617-18.2%
Idaho$4$3715107-20.2%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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