88325

Surgical pathology consultation and report, comprehensive

Medicare pricing data for 228 providers across 27 states

🤖AI Overview

This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Surgical pathology consultation and report, comprehensive (HCPCS code 88325) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $159.94, but hospitals typically charge $413.92 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$31.99

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $159.94, your out-of-pocket cost would be approximately $31.99. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$159.94
Average Hospital Charge
$413.92
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$413.92
Medicare Allowed$159.94
Medicare Payment$125.44

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $125.44 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$175$848846+9.7%
California$166$256244,140+3.8%
Massachusetts$165$749232+3.3%
Illinois$163$659345+2.0%
Connecticut$163$630137+1.6%
Washington$158$325414-1.0%
Colorado$156$603116-2.4%
Texas$155$31912481-3.2%
Minnesota$154$680911,667-4.0%
Florida$153$5641479-4.2%
Missouri$153$629312-4.3%
Arizona$151$78112432-5.3%
Georgia$150$6093144-6.1%
Utah$149$3192335-6.7%
New Mexico$149$1,003117-6.8%
Ohio$149$5276198-7.0%
District of Columbia$146$490223-8.5%
New Jersey$142$951323-11.4%
Pennsylvania$141$67915104-11.9%
Tennessee$139$435511-12.9%
Maryland$138$6545261-14.0%
Michigan$133$44532273-17.1%
Virginia$131$470626-18.1%
Kentucky$128$368439-20.3%
Oklahoma$128$510815-20.3%
Louisiana$127$375536-20.5%
North Carolina$127$58018400-20.5%

⚠️ 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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