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See a sample rate comparisonCPT 82261 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.
Vitamin B Enzyme Test, This Test Checks A Blood Sample For The Presence Of An Enzyme That Helps The Body Process Biotin. Biotin Is One Of The B Vitamins That Helps Process Proteins And Carbohydrates.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $16.87 national lab fee schedule rate (2026) · View Medicare rates for 82261 |
| Medicaid Fee Schedule | $15.52 median of the 8 states in the free preview · View Medicaid rates for 82261 |
National average reimbursement for CPT 82261 by major payers:
$14.82
$11.86
$17.10
$25.07
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CPT 82261
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$40.00Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$19.75Published ratePrisma Health-Upstate, Prisma Health Ctr For Ped & Int Med-West
Prisma Health - Upstate
$15.18Published rateNicole Schwab
Allergy & Asthma Of Dupage, S.C.
$13.50Published rateLambert Laperouse
St Tammany Emergency Physicians Group LLC
$8.33Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 82261 vs. Other Chemistry Procedures Codes
The CPT 82261 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 82261 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 |
|---|---|---|
| 82261-CPT | Low | Vitamin B Enzyme Test, This Test Checks A Blood Sample For The Presence Of An Enzyme That Helps The Body Process Biotin. Biotin Is One Of The B Vitamins That Helps Process Proteins And Carbohydrates. |
| 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) |
| 82272-CPT | Low | Occult Bld Feces 1 3 Tests, Blood Occult By Peroxidase Activity Eg Guaiac Qualitative Feces 1 3 Simultaneous Determinations Performed For Other Than Colorectal Neoplasm Screening |
| 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 82261. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82261 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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