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See a sample rate comparisonCPT 82040 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.
Albumin Protein Lab Test, Albumin Is A Protein Found In Urine Blood Spinal Fluid And Amniotic Fluid. Elevated Albumin In The Urine May Indicate Diabetes Or Pregnancy. In Other Fluids The Albumin Level Can Provide Information About Nutrition Status Or Disease.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $4.95 national lab fee schedule rate (2026) · View Medicare rates for 82040 |
| Medicaid Fee Schedule | $4.89 median of the 8 states in the free preview · View Medicaid rates for 82040 |
National average reimbursement for CPT 82040 by major payers:
$3.79
$3.45
$6.04
$7.25
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CPT 82040
5 of 25 sample ratesHigher to lower in this preview
Emerus Bhs Sa Thousand Oaks, LLC, Baptist Neighborhood Hospital Hausman
Emerus Bhs Sa Thousand Oaks LLC
$10.50Published rateTenet Hospitals Limited, The Hospitals Of Providence East Campus
$4.94Published rateMethodist Hospitals Of Dallas, Methodist Southlake Medical Center
Methodist Hospitals Of Dallas
$4.94Published rateGonzales Healthcare Systems
$2.91Published rateVhs Harlingen Hospital Company, LLC, Valley Baptist Micro-Hospital Weslaco
$1.37Published rate
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See a sample payer proposalCPT 82040 vs. Other Chemistry Procedures Codes
The CPT 82040 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 82040 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 |
|---|---|---|
| 82013-CPT | Low | Nervous System Blood Test, Acetylcholinesterase Is An Enzyme Present In The Blood That Is Essential For A Healthy Nervous System. The Test Is Used Most Often To Assess Exposure To Pesticides That Contain Organophosphates. |
| 82016-CPT | Low | Fatty Acid Enzyme Test, Acylcarnitine Is An Enzyme In The Blood That Helps To Metabolize Long-Chain Fatty Acids. Tests Check For The Presence Of The Enzyme Or The Amount In The Sample. Deficiencies Are Rare And Usually Genetic. |
| 82017-CPT | Low | Fatty Acid Enzyme Test, Acylcarnitine Is An Enzyme In The Blood That Helps To Metabolize Long-Chain Fatty Acids. Tests Check For The Presence Of The Enzyme Or The Amount In The Sample. Deficiencies Are Rare And Usually Genetic. |
| 82040-CPT | Low | Albumin Protein Lab Test, Albumin Is A Protein Found In Urine Blood Spinal Fluid And Amniotic Fluid. Elevated Albumin In The Urine May Indicate Diabetes Or Pregnancy. In Other Fluids The Albumin Level Can Provide Information About Nutrition Status Or Disease. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82040 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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