Understanding Your Pathology Bill
A patient guide to laboratory charges and why they may vary
When your doctor takes a biopsy, it is sent to a pathology laboratory where trained specialists examine the tissue to help diagnose your condition. The type of examination required depends on what the tissue looks like and that is something the pathologist can only determine after the process begins. This guide explains why you may receive more than one charge from the laboratory.
What Happens to Your Biopsy?
Every biopsy goes through the following steps.
Step 1
Tissue received
Your biopsy arrives at the lab. The pathologist logs and examines it visually — this is called a gross examination. Tissue received
Step 2
Microscopic review
Thin slices of tissue are placed on glass slides and reviewed under a microscope. This is standard for nearly all biopsies. Microscopic review
Step 3*
Additional testing
If the initial review raises questions, special dyes, stains, or advanced molecular tests may be needed to reach an accurate diagnosis.
Step 4
Pathology report
All findings are compiled into a report sent to your doctor, who then discusses the results and next steps with you. Pathology report
*Additional charges can arise at Step 3 if further testing is needed
Common Charges and CPT Codes
CPT (Current Procedural Terminology) codes are standardized billing codes used by all medical providers. Below are the most common codes you may see on a lab bill, along with plain-language explanations.
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Why Your Charges May Vary
It is common for a single biopsy to result in more than one charge. Here is why:
Examination findings vary:
The pathologist cannot know in advance what tests will be needed. Just like an ER doctor may order more tests based on what they find, a pathologist may require additional stains or specialized testing once they begin examining your tissue.
Each test is billed separately:
A single biopsy specimen can generate multiple CPT codes if it requires a standard exam plus one or more special stains or advanced tests. Each step involves different laboratory materials, equipment, and specialized expertise.
Tissue complexity drives the level of service:
A simple skin tag removal is examined at a lower billing level than a mass removed from an organ — even if your doctor collected both specimens during the same appointment.
The laboratory bills separately from your doctor:
Your physician charges for the procedure to collect the tissue. The laboratory charges separately for examining it. You may receive two different bills from two different providers for the same visit.
View and download the informational PDF here.