CPT 82164 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 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 82164 |
| Medicaid Fee Schedule | View Medicaid rates for 82164 |
National average reimbursement for CPT 82164 by major payers:
$12.71
$10.50
$17.11
$21.43
CPT 82164 vs. Other Chemistry Procedures Codes
The CPT 82164 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 82164 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 |
|---|---|---|
| 82163-CPT | Low | Test Blood Pressure Regulation, The Blood Pressure Regulation Test Measures Production Of Angiotensin Ii. This Compound Is One Of The Peptides (Amino Acid Chain) That Ensures Blood Pressure Is Adequate For Any Given Activity. |
| 82164-CPT | Low | Enzyme (Ace) Blood Test, This Blood Test Measures Angiotensin I Converting Enzyme (Ace). Ace Enables Blood Vessels To Expand Or Contract. |
| 82274-CPT | Low | Assay Test For Blood Fecal, Blood Occult By Fecal Hemoglobin Determination By Immunoassay Qualitative Feces 1 3 Simultaneous Determinations |
| 82306-CPT | Low | Test For Vitamin D Deficiency, This Blood Test Measures The Amount Of Vitamin D Present In The Body And The Bodys Ability To Store It. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82164. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82164 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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