88331

Pathology examination of specimen during surgery, first tissue block

Medicare pricing data for 10,925 providers across 52 states

🤖AI Overview

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 specimen during surgery, first tissue block (HCPCS code 88331) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $71.46, but hospitals typically charge $228.58 — a 3.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$14.29

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $71.46, your out-of-pocket cost would be approximately $14.29. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$71.46
Average Hospital Charge
$228.58
Markup Ratio
3.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$228.58
Medicare Allowed$71.46
Medicare Payment$56.41

Hospitals charge 3.2x more than what Medicare allows for this procedure. Medicare actually pays $56.41 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Delaware$90$199443,341+26.6%
Arkansas$85$13211812,596+18.8%
Hawaii$83$191391,179+16.8%
Virginia$83$1892289,722+16.2%
Wyoming$81$29913148+13.5%
Idaho$81$212411,573+12.9%
Puerto Rico$80$1761794+11.3%
Alaska$79$44013686+10.0%
Florida$78$22576041,909+9.4%
Tennessee$76$16828811,090+6.6%
Texas$76$23485326,188+6.4%
California$75$2431,04324,477+5.3%
Maryland$74$2152067,277+3.9%
Alabama$73$1881505,559+2.7%
South Carolina$73$2531656,817+2.3%
New Mexico$71$219491,168-0.7%
Nevada$70$227611,213-1.9%
Massachusetts$70$25141210,136-2.0%
Georgia$70$2412557,090-2.7%
New Jersey$69$2612215,642-3.0%
Arizona$69$2072208,065-3.2%
New York$69$24769816,051-3.5%
Oklahoma$68$2141022,766-4.4%
Pennsylvania$68$23352313,045-4.6%
Washington$68$1902405,019-5.3%
North Carolina$67$2323007,971-6.0%
District of Columbia$67$19141972-6.6%
Montana$67$18535868-6.9%
Rhode Island$66$19052575-7.1%
Indiana$66$2301895,459-7.6%
Kentucky$66$2091484,469-7.7%
Colorado$66$2251933,880-7.8%
Oregon$66$2301412,919-7.8%
Vermont$66$27029330-8.2%
Utah$66$1931022,619-8.3%
Nebraska$65$228812,450-9.6%
Illinois$65$27144210,118-9.6%
Connecticut$64$2351622,043-10.3%
Minnesota$64$29329710,719-10.3%
Wisconsin$64$4102374,717-10.9%
West Virginia$63$200631,303-12.0%
New Hampshire$62$61058864-12.6%
Mississippi$62$202782,435-12.7%
Iowa$62$2321114,771-12.8%
South Dakota$62$208451,401-13.3%
Ohio$62$24043210,596-13.5%
Missouri$61$2212255,216-14.1%
Kansas$61$2021273,273-14.2%
Michigan$61$2213245,129-14.5%
North Dakota$61$19539651-15.2%
Louisiana$58$1961574,452-18.6%
Maine$56$173521,138-21.1%

⚠️ 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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