CPT88305

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

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 South Carolina averages $67.

Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers. For example 29001.
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South Carolina Medicare physician rate (2026)

-5.0% vs national

Single statewide locality.

South Carolina (Hospital)
$34.23
Physician reading only
Private plan est.
$87–$133
~130–200% of Medicare
Cash / self-pay est.
$53–$100
~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 South Carolina

Check your ZIP code for your region of South Carolina, whether Charleston and the Lowcountry, Columbia and the Midlands, Greenville-Spartanburg in the Upstate, or Myrtle Beach and the Grand Strand.

What pathology exam of biopsy tissue costs at hospitals near you

Everything above is a national average. The hospital you pick in South Carolina 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 29001.

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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 South Carolina the office and hospital physician lines for this CPT differ by $32.38.

National vs South Carolina

National office$70.14
National hospital (physician)$35.07
South Carolina vs national5% below the national office rate of $70.14

Where South Carolina ranks for this CPT

Rank (lowest physician fee first)#17 of 51
Lowest stateArkansas ($63.46)
Highest stateAlaska ($84.96)

Pathology Exam of Biopsy Tissue and how South Carolina is priced

South Carolina prices through one statewide locality with indices a bit below the national average, so Charleston, Columbia, Greenville, and the rural Pee Dee share the same Medicare-approved amounts. Rapid coastal growth has not led CMS to break out a separate locality, keeping the fee schedule uniform from the mountains to the sea islands. The single set of adjustments makes the statewide figures here directly usable anywhere in the state. Facility fees at hospital-owned locations remain the largest source of price variation for patients.

The state's medical firepower splits three ways: an academic medical center and strong hospital market in Charleston, the capital-region systems in Columbia, and a large Upstate network centered on Greenville. Retiree-heavy coastal areas like Hilton Head and Myrtle Beach have booming demand for Medicare-age care, while the rural I-95 corridor faces some of the state's worst access gaps. Some border residents use Charlotte or Augusta providers.

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 South Carolina: 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 South Carolina averages $67. South Carolina is a single Medicare locality, so the physician rate is the same statewide.

Not on the physician fee schedule. South Carolina 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 South Carolina. 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, $66.61 is Medicare's full rate in South Carolina, covering the test and the reading. In a hospital outpatient department the physician is paid only for the reading (about $34.23) and the hospital is paid separately, which brings the national total to up to about $88. South Carolina ranks #17 of 51 states on the non-hospital rate (5% 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.