CPT 82043 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Pathology and Laboratory Procedures • Chemistry Procedures |
| Common Place of Service | • 81 - Independent Laboratory • 11 - Office |
| Common Modifiers | • None • QW - CLIA Waived Tests • 26 - Professional component |
| Complexity Level | Low |
National average reimbursement for CPT 82043 by major payers:

$5.09

$4.14

$7.14

$9.06
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 82043 | ||||||
United | 82043 | $3.75 | 1629142302 - AJMAL BAIG | 274749421 - TAMPA GENERAL MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
United | 82043 | $3.75 | 1144601667 - RICHARD JACOBSON | 274749421 - TAMPA GENERAL MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
United | 82043 | $3.47 | 1215102041 - ADAM WIENER | 591761147 - (FL) STEPHEN HORNELL MD PA | FL | Dermatology Physician (207N00000X) |
United | 82043 | $2.43 | 1750793584 - GENESISCARE USA OF FLORIDA LLC, EAD UROLOGY | 592485899 | FL | Urology Physician (208800000X) |
United | 82043 | $3.47 | 1205381175 - ST. PETERSBURG DERMATOLOGY, LLC | 813255800 - (FL) ST PETERSBURG DERMATOLOGY LLC | FL | Dermatology Physician (207N00000X) |
United | 82043 | $4.88 | 1801090220 - AMBERLY WOLBER | 770672639 - (KY) LANDMARK UROLOGY PSC | FL | Urology Physician (208800000X) |
United | 82043 | $2.43 | 1598128027 - VICTORIA GAU | 650512900 - SMH PHYSICIAN SERVICES INC | FL | Otolaryngology Physician (207Y00000X) |
United | 82043 | $2.01 | 1235443326 - VISHAL PATEL | 923263386 - (FL) MELIORA HEALTHCARE PLLC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 82043 | $1.20 | 1649664731 - ANDREW KELSEY | 461243081 | FL | Dermatology Physician (207N00000X) |
United | 82043 | $2.43 | 1770745028 - GIOVANNA DA SILVA SOUTHWICK | 650003177 - CLEVELAND CLINIC FLORIDA A NONPROFIT CORPORATION | FL | Colon & Rectal Surgery Physician (208C00000X) |
United | 82043 | $1.60 | 1376079269 - JOSEPH IVEY | 620816934 - (TN) TENNESSEE VALLEY UROLOGY CENTER PC | FL | Urology Physician (208800000X) |
United | 82043 | $1.37 | 1457307928 - WALTER HAYNE | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
United | 82043 | $0.83 | 1598922825 - TAM MAI | 464101327 - (FL) MIAMI UROLOGY SEXUAL WELLNESS INSTITUTE PA | IL | Surgery Physician (208600000X) |
United | 82043 | $2.01 | 1235397662 - TROY MASOURAS | 921919591 - (FL) PRECISION HEALTHCARE SPECIALISTS LLC | FL | Surgery Physician (208600000X) |
United | 82043 | $3.47 | 1639581903 - ANDRE COOMBS | 273818647 | FL | Surgery Physician (208600000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 82043 vs. Other Chemistry Procedures Codes
The CPT 82043 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 82043 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 |
|---|---|---|
| 82042-CPT | Low | Albumin; Other Source Quantitative Each Specimen(Desc Revised 1/1/2018) |
| 82043-CPT | Low | Albumin; Urine (Eg Microalbumin) Quantitative (Desc Revised 1/1/2018) |
| 82044-CPT | Low | Albumin; Urine (Eg Microalbumin) Semiquantitative (Eg Reagent Strip Assay) (Desc Revised 1/1/2018) |
| 82045-CPT | Low | Albumin; Ischemia Modified |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82043. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82043 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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