CPT88305

How Much Does a Pathology Exam of Biopsy Tissue Cost in Nebraska?

Tissue exam by pathologist

$88Hospital outpatient total2026 Medicare, physician + facility

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 Nebraska averages $66.

Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers. For example 68001.
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Nebraska Medicare physician rate (2026)

-5.5% vs national

Single statewide locality.

Nebraska (Hospital)
$34.07
Physician reading only
Private plan est.
$86–$133
~130–200% of Medicare
Cash / self-pay est.
$53–$99
~80–150% of Medicare

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.

Physician reading alone
$35
Only 40% of the hospital total

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 Nebraska

Try a ZIP lookup for your part of Nebraska, from Omaha and Lincoln to Grand Island, Kearney, North Platte, Scottsbluff, and the Sandhills.

What pathology exam of biopsy tissue costs at hospitals near you

Everything above is a national average. The hospital you pick in Nebraska moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

For example 68001.

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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 Nebraska the office and hospital physician lines for this CPT differ by $32.18.

National vs Nebraska

National office$70.14
National hospital (physician)$35.07
Nebraska vs national6% below the national office rate of $70.14

Where Nebraska ranks for this CPT

Rank (lowest physician fee first)#13 of 51
Lowest stateArkansas ($63.46)
Highest stateAlaska ($84.96)

Pathology Exam of Biopsy Tissue and how Nebraska is priced

One locality prices all of Nebraska, with low geographic indices typical of the Plains, so Omaha, Lincoln, and the Sandhills ranch country share the same Medicare-approved amounts. The statewide setup means Nebraska's largest metro carries no fee schedule premium over its most remote village. Practice costs in Omaha do run above the rural average, but CMS averages that into one set of factors. Patients can treat the statewide numbers here as applicable anywhere in Nebraska.

Omaha is the state's medical anchor, with an academic medical center of national standing and a market that also serves western Iowa, while Lincoln adds a second urban hub. Outstate Nebraska depends heavily on critical access hospitals, and residents of the Panhandle often find Denver or Rapid City closer than Omaha for specialty care. Long travel distances are simply part of rural care planning here.

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?

Pathology Exam of Biopsy Tissue in Nebraska: 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 Nebraska averages $66. Nebraska is a single Medicare locality, so the physician rate is the same statewide.

Not on the physician fee schedule. Nebraska 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 $13 for the office physician line or $7 for the hospital physician line in Nebraska. 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, $66.25 is Medicare's full rate in Nebraska, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $34.07) and the hospital is paid separately, which brings the national total to up to about $88. Nebraska ranks #13 of 51 states on the non-hospital rate (6% below the national office rate of $70.14).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.