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    v1.0.30
    OpenPayerBilling CodesClinical Pathology ConsultationsCPT cpt-80506-pathology-consultation-add-on-extended-time
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    CPT 80506: Pathology Consultation, Additional 30-Minute Unit

    Medicare pays $43 on average nationally for this procedure.

    CPT code 80506 is an add-on pathology consultation code used when a pathologist documents at least 75 minutes spent on a consultation date; it is reported in addition to 80505 for the first 60 minutes, with one unit of +80506 representing each additional 30 minutes (or at least 15 additional minutes) of pathology consultation time-based clinical service, typically performed in an inpatient or outpatient hospital or laboratory setting at the request of a physician or other qualified healthcare provider.

    For related coverage guidance, see recent payer policy updates: Long-Acting Injectable Antiretroviral Agents for HIV, B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays.

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    Clinical & Coding Specifications

    Clinical Context

    A surgical or oncology team requests a pathology consultation when a complex tumor case requires subspecialty review or treatment planning. A 62-year-old male with a previously resected colorectal mass presents with equivocal margins and unusual histologic features on initial surgical pathology. The operating surgeon requests a pathologist consultation to review the slides, review prior outside pathology, correlate immunohistochemistry, and provide a second opinion for staging and margin status. The pathologist documents direct review of materials, discussion with the treating physician, and synthesis of findings, spending at least 75 minutes on the consultation date. The typical workflow includes: receiving request, retrieving and reviewing slides and clinical history, performing additional slide review or ordering ancillary stains if needed (reported separately), documenting a consultative report, and communicating findings to the treating physician or tumor board. Typical sites of service are hospital inpatient, outpatient hospital, and independent pathology laboratories where pathologist-to-physician consultations are performed.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    80505Pathology consultation; first 60 minutes (at request of physician)Base code for the initial 60 minutes of a pathology consult; 80506 is reported when additional time beyond 60 minutes is required.
    88342Surgical pathology, gross and microscopic examination, with report; single specimenCommonly performed prior to or alongside consults when additional slide review or resection specimen interpretation is needed.
    88360Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stainFrequently used as ancillary testing to clarify diagnosis during a consultative review (billed separately).
    89240Molecular pathology procedure, targeted sequencingAncillary molecular testing ordered as part of consultative diagnostic workup (billed separately).

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    208000000X
    111NS0005X
    101YP1600X
    2081S0010X
    2251G0304X
    207VX0000X
    207XP3100X

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    10 rows

    PolicyPayerEffective Date
    Long-Acting Injectable Antiretroviral Agents for HIVColorado Rocky Mountain Health Plans2026-10-01
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01

    Related Codes

    CPT-80503-PATHOLOGY-CONSULTATION-LIMITED-STRAIGHTFORWARD

    CPT 80503: Pathologist Consultation, Straightforward Medical Judgment

    CPT-80504-PATHOLOGY-CONSULTATION-MODERATE-COMPLEXITY

    CPT 80504: Pathology Consultation, Moderate Complexity

    CPT-80505-PATHOLOGY-CONSULTATION-HIGH-COMPLEXITY-41-60-MINUTES

    CPT 80505: Pathology Consultation, High Complexity

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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