CPT 82128 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 | Chemistry Procedures Pathology and Laboratory Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component 32 |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 82128 |
National average reimbursement for CPT 82128 by major payers:
$12.33
$9.84
$14.55
$20.16
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 82128 | $8.32 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 82128 | $19.37 | 1548588841 - HARLINGEN VAMC | 272466786 | TX | General Acute Care Hospital (282N00000X) |
United | 82128 | $13.87 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 82128 | $7.75 | 1366400376 - SUNRISE HOME HEALTH CARE INC. | 650307774 - (FL) SUNRISE HOME HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 82128 | $7.49 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 82128 | $8.14 | 1447317110 - BAPTIST HEALTH CARE, INC., BAPTIST HOME HEALT CARE AND MEDICAL EQUIPMENT | 590657322 - BAPTIST HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 82128 | $26.70 | 1477516466 - SCOTT & WHITE MEMORIAL HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE | 742958277 - SCOTT & WHITE CLINIC | TX | General Acute Care Hospital (282N00000X) |
United | 82128 | $13.86 | 1962472431 - COASTAL CAROLINA MEDICAL CENTER, INC., COASTAL CAROLINA HOSPITAL | 934580630 | SC | General Acute Care Hospital (282N00000X) |
United | 82128 | $7.92 | 1891774519 - LEON HOME HEALTH, LLC, LEON AT HOME | 261288029 | FL | Home Health Agency (251E00000X) |
United | 82128 | $7.94 | 1942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY | 741282696 - ST JOSEPH REGIONAL HEALTH CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 82128 | $25.70 | 1710314141 - ST. LUKES HOSPITAL AT THE VINTAGE | 263734606 - (TX) ST LUKES HOSPITAL AT THE VINTAGE | TX | General Acute Care Hospital (282N00000X) |
United | 82128 | $25.70 | 1942208616 - ST. LUKE'S COMMUNITY HEALTH SERVICES, ST. LUKE'S THE WOODLANDS HOSPITAL | 760536234 - (TX) ST LUKES COMMUNITY HEALTH SERVICES | TX | General Acute Care Hospital (282N00000X) |
United | 82128 | $12.47 | 1487639175 - KNOX COUNTY HOSPITAL DISTRICT, KNOX COUNTY HOSPITAL DISTRICT | 750808798 | TX | General Acute Care Hospital (282N00000X) |
United | 82128 | $13.86 | 1295036770 - CRESCENT CITY SURGICAL CENTRE OPERATING COMPANY, L.L.C. | 270508997 - (LA) CRESCENT CITY SURGICAL CENTRE | LA | General Acute Care Hospital (282N00000X) |
United | 82128 | $17.02 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
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 82128 vs. Other Pathology and Laboratory Procedures Codes
The CPT 82128 code is part of the Chemistry Procedures services used for Pathology and Laboratory 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 82128 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 |
|---|---|---|
| 82127-CPT | Low | Amino Acid Test, This Test Verifies Whether And Which Amino Acids Are Present In A Blood Or Urine Sample. Amino Acids Help Digest Proteins. |
| 82128-CPT | Low | Amino Acid Test, This Test Verifies Whether And Which Amino Acids Are Present In A Blood Or Urine Sample. Amino Acids Help Digest Proteins. |
| 82131-CPT | Low | Amino Acid Test, This Test Measures The Quantity Of One Or More Amino Acids Present In A Blood Or Urine Sample. Amino Acids Help Digest Proteins. |
| 82136-CPT | Low | Amino Acid Test, This Test Measures The Quantity Of One Or More Amino Acids Present In A Blood Or Urine Sample. Amino Acids Help Digest Proteins. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82128. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82128 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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