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See a sample rate comparisonCPT 82043 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 | $5.78 national lab fee schedule rate (2026) · View Medicare rates for 82043 |
| Medicaid Fee Schedule | $5.445 median of the 8 states in the free preview · View Medicaid rates for 82043 |
National average reimbursement for CPT 82043 by major payers:
$5.09
$4.14
$7.14
$8.91
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CPT 82043
5 of 25 sample ratesHigher to lower in this preview
Erin Kaye
University Of Miami
$7.51Published rateSt. Petersburg Dermatology, LLC
St Petersburg Dermatology LLC
$3.47Published rateRoy Cardoso
Baptist Health Medical Group Orthopedics LLC
$2.01Published rateChristian Birkedal
Memorial Health Systems Inc
$1.44Published rateDavid Klein
Kennedy White Riggs Orthopedic Associates
$0.86Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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 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. |
| 82043-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. |
| 82044-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. |
| 82045-CPT | Low | Heart Attack Protein Test, The Test Is Performed To Detect Acute Heart Injury. When Blood Flow To The Heart Has Been Blocked (Ischemia) Albumin Protein Will Be Unable To Bind To Testing Mediums. |
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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Frequently Asked Questions
You can often ask your healthcare provider for an estimate directly. For a more detailed understanding of potential costs based on specific CPT codes and your location, Payerprice offers a fee schedule lookup tool. This tool allows users to search with CPT codes and specific locations to get a better idea of expected fees for various medical services.
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services to health insurance companies. These codes are fundamental for billing and reimbursement, as they dictate what services were performed. The fee associated with a specific CPT code can vary significantly based on the provider, geographical location, and your insurance plan.
Healthcare costs can vary due to a multitude of factors, including the type of facility (e.g., hospital vs. outpatient clinic), geographic location, the provider's specific pricing structure, their negotiated rates with insurance companies, the complexity of the service, and the overhead costs associated with their practice. These variables contribute to wide differences in prices for the same medical procedure.
To get an estimate for a specific medical procedure using its CPT code and your location, you should use a specialized lookup tool. Payerprice provides a fee schedule lookup tool where you can input the relevant CPT code and your desired location to search for typical fee schedules and obtain an estimated cost for the service.
These are common terms in health insurance: - **Deductible:** This is the amount you must pay out-of-pocket for covered medical services before your insurance company begins to pay. - **Copay (or Copayment):** This is a fixed amount you pay for a covered healthcare service after you've paid your deductible (though some services might have a copay before the deductible is met). For example, a $30 copay for a doctor's visit. - **Coinsurance:** This is a percentage of the cost of a covered healthcare service that you pay after you've met your deductible. For instance, if your coinsurance is 20%, your insurance pays 80% and you pay 20% of the remaining bill.