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#131 of 11K

88305

Surgical pathology, gross and microscopic examination

Surgical pathology, gross and microscopic examination is the #131 most-billed Medicaid procedure code, with $1.44B in payments across 33.4M claims from 2018–2024. The national median cost per claim is $35.80. Costs vary widely — the 90th percentile is $87.92 per claim, 2.5× the median.

Total Paid

$1.44B

0.13% of all spending

Total Claims

33.4M

Providers

8K

Avg Cost/Claim

$43

National Cost Distribution

How much do providers bill per claim for 88305? Based on 8K providers billing this code nationally.

Median

$35.80

Average

$46.08

Std Dev

$70.84

Max

$4,546.63

Percentile Distribution (Cost per Claim)

p10
$5.25
p25
$19.87
Median
$35.80
p75
$55.74
p90
$87.92
p95
$120.17
p99
$224.69

50% of providers bill between $19.87 and $55.74 per claim for this code.

90% bill between $5.25 and $87.92.

Top 1% bill above $224.69.

About This Procedure

HCPCS code 88305 (Surgical pathology, gross and microscopic examination) was billed by 8K providers across 33.4M claims, totaling $1.44B in Medicaid payments from 2018–2024. This code was used for 28.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$35.80

Providers Billing

8K

National Spending

$1.44B

Avg/Median Ratio

1.29×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 88305

#ProviderTotal Paid
11740460583$11.5M
2Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$9.5M
31598760985$9.0M
41205835600$8.9M
51174503999$8.5M
6Unilab Corporation

West Hills, CA · Clinical Medical Laboratory

$8.5M
71871627067$8.3M
8Associated Pathologists, Llc

Nashville, TN · Medical Genetics, Clinical Genetics (M.D.)

$7.8M
91467433292$7.7M
101326086745$6.9M
11Bioreference Health Llc

Elmwood Park, NJ · Clinical Medical Laboratory

$6.7M
12Montefiore Medical Center

Bronx, NY · Anesthesiology

$6.1M
131033173182$5.8M
141134119233$5.8M
151043275787$5.6M
161942374517$5.5M
17Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$5.5M
181962480608$5.4M
191346271251$5.4M
201225016140$5.2M

Showing top 20 of 8K providers billing this code