How Much Does a Pathology Exam of Biopsy Tissue Cost in Montana?
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 Montana averages $70.
- ✓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
Montana Medicare physician rate (2026)
0.0% vs nationalSingle statewide locality.
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 Montana
Look up your ZIP for local context, whether you are in Billings, Missoula, Bozeman, Great Falls, Helena, Kalispell, or one of Montana's frontier counties.
What pathology exam of biopsy tissue costs at hospitals near you
Everything above is a national average. The hospital you pick in Montana 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 59001.
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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 Montana the office and hospital physician lines for this CPT differ by $35.07.
National vs Montana
Where Montana ranks for this CPT
Pathology Exam of Biopsy Tissue and how Montana is priced
Montana runs on a single statewide locality with geographic indices near the bottom of the national range, so its published Medicare rates are uniform across nearly 150,000 square miles. Billings and a remote Hi-Line town share identical adjustment factors, a simplicity that belies the enormous distances involved in actually reaching care. CMS applies a rural floor to work adjustments that benefits frontier states like this one. For pricing purposes, Montana is one market; for access purposes, it is dozens of small ones.
Billings hosts the state's largest medical community and serves as a referral hub not just for Montana but for northern Wyoming and the western Dakotas, with Missoula, Great Falls, Bozeman, and Kalispell anchoring their own regions. Frontier counties may be hours from the nearest hospital that performs a given procedure. Some Montanans travel to Salt Lake City, Denver, or Seattle for highly specialized care.
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 Montana
Pathology Exam of Biopsy Tissue in other states
Pathology Exam of Biopsy Tissue in Montana: 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 Montana averages $70. Montana is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. Montana uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
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 Montana. 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, $70.14 is Medicare's full rate in Montana, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $35.07) and the hospital is paid separately, which brings the national total to up to about $88. Montana ranks #35 of 51 states on the non-hospital rate (within 2% of the national office rate of $70.14).