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See a sample rate comparisonCPT 82009 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Ketone Test (Blood Acidity), Ketones Are Waste Products Of Fat Digestion. If They Are Not Removed Well The Blood Can Become Acidic. One Blood Test Uses Coloring To Check For Ketones. Another Counts The Number Present. Both Tests Help Assess Metabolic Disorders Especially In Children.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 21 - Inpatient Hospital 23 - Emergency Room |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $4.52 national lab fee schedule rate (2026) · View Medicare rates for 82009 |
| Medicaid Fee Schedule | $4.16 median of the 8 states in the free preview · View Medicaid rates for 82009 |
National average reimbursement for CPT 82009 by major payers:
$3.85
$3.14
$4.94
$6.81
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CPT 82009
5 of 25 sample ratesHigher to lower in this preview
St Lukes Community Development Corporation, St Lukes Sugar Land Hospital
St Lukes Community Development Corporation-Sugar Land
$8.36Published rateChca Clear Lake Lp, Hca Houston Healthcare Clear Lake
$4.51Published rateChca Pearland, L.P., Hca Houston Healthcare Pearland
$4.51Published rateNorthwest Texas Healthcare System Inc, Northwest Texas Healthcare System
$3.69Published rateEthicus Hospital Dfw LLC, Legent Orthopedic Hospital
Ethicus Hospital Dfw
$1.89Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 82009 vs. Other Chemistry Procedures Codes
The CPT 82009 code is part of the Pathology and Laboratory Procedures services used for Chemistry Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 82009 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 81560-CPT | Moderate | Trnsplj Pd Lvr Bwl Cd154 Cll, Transplantation Medicine Allograft Rejection Pediatric Liver And Small Bowel Measurement Of Donor And Third Party Induced Cd154 T Cytotoxic Memory Cells Utilizing Whole Peripheral Blood Algorithm Reported As A Rejection Risk Score |
| 81595-CPT | High | Cardiology Hrt Trnspl Mrna, Cardiology Heart Transplant Mrna Gene Expression Profiling By Real Time Quantitative Pcr Of 20 Genes 11 Content And 9 Housekeeping Utilizing Subfraction Of Peripheral Blood Algorithm Reported As A Rejection Risk Score |
| 81596-CPT | Low | Nfct Ds Chrnc Hcv 6 Assays, Infectious Disease Chronic Hepatitis C Virus Hcv Infection Six Biochemical Assays Alt A2 Macroglobulin Apolipoprotein A 1 Total Bilirubin Ggt And Haptoglobin Utilizing Serum Prognostic Algorithm Reported As Scores For Fibrosis And Necroinflammatory Activity In Liver |
| 82009-CPT | Low | Ketone Test (Blood Acidity), Ketones Are Waste Products Of Fat Digestion. If They Are Not Removed Well The Blood Can Become Acidic. One Blood Test Uses Coloring To Check For Ketones. Another Counts The Number Present. Both Tests Help Assess Metabolic Disorders Especially In Children. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82009. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82009 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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