How Much Does a Pathology Exam of Biopsy Tissue Cost in Maryland?
Tissue exam by pathologist
$88Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, a pathology exam of biopsy tissue costs up to about $88 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Maryland averages $72, from $71 in Rest of Maryland to $74 in Baltimore/Surr. Cntys.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Maryland Medicare physician rate (2026)
+3.3% vs nationalAverage of 2 localities. Office range $70.87–$73.98.
What the whole procedure costs
The office rate above is what an imaging center, lab or office is paid for the whole test. In a hospital, the facility bills its own fee and the physician bills only the reading. These are 2026 national Medicare amounts.
Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. For a test like this the physician in a hospital bills only the reading (the professional component); outside a hospital one global fee covers the whole test, shown in the office rate above. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in Maryland
A ZIP lookup matters in Maryland because three different locality treatments are in play: check whether you fall in the Baltimore area, the DC suburbs like Bethesda and Silver Spring, or rest-of-state regions like Frederick, Hagerstown, and the Eastern Shore.
What pathology exam of biopsy tissue costs at hospitals near you
Everything above is a national average. The hospital you pick in Maryland moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 20601.
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What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Maryland the office and hospital physician lines for this CPT differ by $36.58.
National vs Maryland
Where Maryland ranks for this CPT
CPT 88305 by Maryland locality
| Locality | Office |
|---|---|
| baltimore/surr. cntys | $73.98 |
| rest of maryland | $70.87 |
PE GPCI ranges from 1.012 to 1.073 in Maryland. That index is why the same CPT is not one price statewide.
Pathology Exam of Biopsy Tissue and how Maryland is priced
Maryland's Medicare physician pricing is split geographically: Baltimore and its surrounding counties form one locality, the rest of the state another, and, unusually, the Washington suburbs including Montgomery and Prince George's counties are priced inside the District of Columbia's high-cost locality rather than either Maryland one. That three-way carve means a Rockville procedure is approved at DC-area rates while an identical one in Frederick or Salisbury is not. Baltimore-area adjustments sit above rest-of-state levels but below the DC locality. Few states have their pricing shaped this much by a neighboring jurisdiction.
Maryland is also the only state with an all-payer rate-setting system for hospital services, so hospital-side billing works differently here than anywhere else in the country, though physician fees still follow the standard Medicare schedule. Baltimore's academic medical centers rank among the most prominent in the world and draw patients globally. The Eastern Shore and western Maryland are far more rural, with patients often traveling to Baltimore, Annapolis, or across state lines.
This procedure: CPT 88305 covers a pathologist examining tissue from a biopsy or minor surgery under a microscope: a skin biopsy, a polyp removed during a colonoscopy, or a breast or prostate core, for example. The lab processes the tissue into stained glass slides, and a pathologist, often a dermatopathologist for skin samples, reads them and writes the diagnosis report. It is one of the most frequently billed pathology codes, and it is billed per specimen, so several biopsies from one procedure often produce several charges.
What Is Pathology Exam of Biopsy Tissue?
CPT 88305 covers a pathologist examining tissue from a biopsy or minor surgery under a microscope: a skin biopsy, a polyp removed during a colonoscopy, or a breast or prostate core, for example. The lab processes the tissue into stained glass slides, and a pathologist, often a dermatopathologist for skin samples, reads them and writes the diagnosis report. It is one of the most frequently billed pathology codes, and it is billed per specimen, so several biopsies from one procedure often produce several charges.
What Affects the Cost
- –Each separately submitted specimen is billed as its own unit, so three polyps sent in three containers can mean three charges.
- –Special stains or immunohistochemistry, used when the diagnosis is not clear on routine slides, are billed with additional codes such as 88312 or 88342.
- –An independent lab usually bills one global fee, while a hospital lab bills the tissue processing on its own claim and the pathologist bills the reading.
- –Out-of-network lab bills are a common surprise, because patients rarely choose the lab that receives their biopsy.
- –An outside second opinion on the slides is billed with separate consultation codes.
Questions to Ask Before Booking
- 1.Which lab will the tissue go to, and is it in my network?
- 2.How many specimens will be sent, and will each one be billed?
- 3.Will special stains or extra tests be run, and would you tell me first?
- 4.Is a dermatopathologist or other subspecialist reading the slides, and are they in network?
- 5.If I get a bill from a lab I did not choose, who do I contact to have it reprocessed?
Other featured procedures in Maryland
Pathology Exam of Biopsy Tissue in other states
Pathology Exam of Biopsy Tissue in Maryland: questions
Under 2026 Medicare rates, a pathology exam of biopsy tissue costs up to about $88 in total at a hospital outpatient department, counting both the physician and the facility (national rates). Outside a hospital, at an independent imaging center, lab or office, Medicare's full rate in Maryland averages $72, from $71 in Rest of Maryland to $74 in Baltimore/Surr. Cntys. Enter a ZIP for the exact Maryland locality.
Yes. CMS splits Maryland into 2 payment localities. For this CPT the office physician fee spans $3.11 from the lowest to highest locality. A ZIP lookup matters in Maryland because three different locality treatments are in play: check whether you fall in the Baltimore area, the DC suburbs like Bethesda and Silver Spring, or rest-of-state regions like Frederick, Hagerstown, and the Eastern Shore.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $14 for the office physician line or $7 for the hospital physician line in Maryland. Medigap may cover that 20%. This is not the hospital facility fee.
It depends on where the test is done. At an independent imaging center, lab or office, $72.43 is Medicare's full rate in Maryland, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $35.85) and the hospital is paid separately, which brings the national total to up to about $88. Maryland ranks #41 of 51 states on the non-hospital rate (3% above the national office rate of $70.14).