{
    "code": "88305",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/88305/2016/A",
    "release_specific_url": "https://localishealth.com/cpt/88305/2016/A",
    "description": "A pathologist's examination of a tissue specimen by eye and then under the microscope, at the level covering most diagnostic biopsies. This is the workhorse of the surgical pathology family and by far the most frequently reported of its levels, because it is what a skin biopsy, a colon polyp, a prostate needle core, a breast biopsy, or an endometrial sample is examined under. What separates it from the level below is that the diagnosis is genuinely in question: the pathologist is deciding whether tissue is normal, inflamed, precancerous, or malignant. Larger cancer resections are handled at higher levels of the same family.",
    "answer": {
        "question": "How much did Medicare pay for CPT 88305 in Q1 2016?",
        "text": "Medicare paid $74.11 for CPT 88305 in the office (non-facility) setting and $74.11 in a facility under the Q1 2016 Physician Fee Schedule, effective January 2016. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 1.1% increase from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2016,
        "quarter": "A",
        "label": "Q1 2016",
        "effective": "January 1 – March 31, 2016",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 74.11,
        "facility": 74.11,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.75,
        "practice_expense_non_facility": 1.29,
        "practice_expense_facility": 1.29,
        "malpractice": 0.03
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.8043,
    "source": {
        "label": "Physician relative value file (Q1 2016)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16a.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2016/A",
        "file": "PPRRVU16_V0122.csv",
        "row": 14492,
        "sha256": "e7973024293c4f8bd19119f0479a6b7bdc36435376c6b05a22fd3cd3cec5b13c"
    },
    "modified_at": "2026-08-04T03:06:29+00:00"
}