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CPT 88307: Surgical Pathology Level V Examination
CPT code 88307 represents a level V surgical pathology examination performed by a physician, generally a pathologist, that includes accessioning, gross and microscopic evaluation, and a formal pathology report. This code is a core component of surgical pathology billing nationally because it captures high-complexity tissue evaluations that inform diagnosis, staging, and treatment planning for conditions such as suspected malignancies and complex benign processes. Accurate coding of 88307 affects clinical documentation, reimbursement, and quality reporting across hospitals and independent pathology laboratories.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis addresses typical sites of service (hospital and independent pathology laboratories) and the clinical context in which level V examinations are used. Readers will find a concise explanation of the clinical service represented by 88307, comparisons to adjacent surgical pathology levels (e.g., level IV and VI), and identification of common ancillary procedures and related codes that frequently appear on the service line. The publication also summarizes coding considerations and the operational steps captured by the service (accessioning through microscopic interpretation) that matter for billing accuracy and claims processing. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 88307 describes a level V surgical pathology examination performed by a physician, typically a pathologist. The service includes accessioning the specimen into the laboratory, gross examination of the specimen, microscopic evaluation, and preparation of a pathology report documenting the findings.
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Service type: Surgical pathology examination, level V
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Typical site of service: Hospital pathology laboratory or independent pathology laboratory (clinical laboratory setting)
National Reimbursement Benchmarks
Medicare’s mean rate of $193.3 sits slightly below BUCA’s average commercial mean of $230.1, indicating that commercial BUCA arrangements pay modestly higher on average for CPT 88307 than Medicare. The proximity of medians and means for several payers suggests mixed skew: Blue Cross Blue Shield’s median of $208.3 is close to its mean of $239.5, while Aetna shows a larger gap between median $198.10 and mean $273.00, implying higher-end outliers raise the average.
Comparing dispersion using the interquartile range (P75 minus P25), Blue Cross Blue Shield has a range of $148.30 and BUCA’s IQR is $154.70, placing them in the mid spread. UnitedHealth Group is tighter at an IQR of $133.40, while Aetna is the widest at $249.60. Cigna’s IQR of $192.70 sits between these extremes. These differences highlight which payers have more concentrated vs. more variable negotiated rates for this CPT code.