CPT 82252 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 | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | None |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 82252 |
| Medicaid Fee Schedule | View Medicaid rates for 82252 |
National average reimbursement for CPT 82252 by major payers:
$4.07
$3.18
$4.78
$6.62
CPT 82252 vs. Other Chemistry Procedures Codes
The CPT 82252 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 82252 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 |
|---|---|---|
| 82239-CPT | Low | Blood Bile Acid Test, This Test Measures The Amount Of Bile Acids Present In The Blood. Bile Acids Play An Important Role In Digestion. If Their Numbers In The Blood Increase This Suggests The Livers Ability To Function Is Reduced. |
| 82252-CPT | Low | Stool Test For Bilirubin, Bilirubin Is A Byproduct Created When Red Blood Cells Break Down. This Test Determines Whether Bilirubin Is Present In A Stool Sample. |
| 82270-CPT | Low | Pathology Stool Exam, Blood Occult By Peroxidase Activity (Eg Guaiac) Qualitative; Feces Consecutive Collected Specimens With Single Determination For Colorectal Neoplasm Screening (Ie Patient Was Provided Three Cards Or Single Triple Card For Consecutive Collection) |
| 82274-CPT | Low | Assay Test For Blood Fecal, Blood Occult By Fecal Hemoglobin Determination By Immunoassay Qualitative Feces 1 3 Simultaneous Determinations |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82252. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82252 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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