CPT88305

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

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 North Dakota averages $70.

Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers. For example 58001.
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North Dakota Medicare physician rate (2026)

-0.6% vs national

Single statewide locality.

North Dakota (Hospital)
$34.87
Physician reading only
Private plan est.
$91–$140
~130–200% of Medicare
Cash / self-pay est.
$56–$105
~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 North Dakota

Enter a ZIP code for your part of North Dakota, whether Fargo, Bismarck, Grand Forks, Minot, or the farm and oil country in between.

What pathology exam of biopsy tissue costs at hospitals near you

Everything above is a national average. The hospital you pick in North Dakota 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 58001.

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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 North Dakota the office and hospital physician lines for this CPT differ by $34.88.

National vs North Dakota

National office$70.14
National hospital (physician)$35.07
North Dakota vs nationalwithin 2% of the national office rate of $70.14

Where North Dakota ranks for this CPT

Rank (lowest physician fee first)#32 of 51
Lowest stateArkansas ($63.46)
Highest stateAlaska ($84.96)

Pathology Exam of Biopsy Tissue and how North Dakota is priced

North Dakota's entire fee schedule flows through one statewide locality whose geographic indices sit near the national floor, lifted partly by the work index floor CMS applies to low-cost states. Fargo and a prairie town on the Canadian border publish identical Medicare-approved amounts. With no metro large enough to justify its own locality, the state is among the most straightforward in the country for Medicare pricing. Oil-patch growth in the west changed local economies but not the fee schedule structure.

Fargo and Bismarck are the state's two care anchors, each dominated by large regional systems that also reach into Minnesota, South Dakota, and Montana, with Grand Forks and Minot serving their own areas. Much of rural North Dakota depends on critical access hospitals, and winter travel adds a genuine planning constraint. Some eastern residents cross into Minnesota for care, particularly toward Fargo-Moorhead's twin market.

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 North Dakota: 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 North Dakota averages $70. North Dakota is a single Medicare locality, so the physician rate is the same statewide.

Not on the physician fee schedule. North Dakota 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 North Dakota. 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, $69.75 is Medicare's full rate in North Dakota, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $34.87) and the hospital is paid separately, which brings the national total to up to about $88. North Dakota ranks #32 of 51 states on the non-hospital rate (within 2% of 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.