CPT 82378 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 |
| Common Modifiers | None 26 - Professional component PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 82378 |
National average reimbursement for CPT 82378 by major payers:
$16.55
$14.98
$23.36
$27.45
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 82378 | $9.27 | 1215017207 - XAVIER CANNELLA | 200180690 - HYPERBARIC & WOUNDCARE, INC. | FL | Surgery Physician (208600000X) |
United | 82378 | $7.96 | 1063409027 - FUAD SHAHIN | 421748185 - (FL) OSCEOLA SURGICAL ASSOCIATES LLC | FL | Surgery Physician (208600000X) |
United | 82378 | $16.02 | 1962449587 - GEORGE BLAKE | 593505307 - (FL) GEORGE BLAKE MD PA | FL | Otolaryngology Physician (207Y00000X) |
United | 82378 | $9.27 | 1710218763 - GENESISCARE USA OF FLORIDA LLC, NAPLES UROLOGY ASSOCIATES | 200678803 - (FL) NAPLES UROLOGY ASSOCIATES, P.A. | FL | Urology Physician (208800000X) |
United | 82378 | $7.96 | 1740215318 - TAPAN PADHYA | 237313346 - UNIVERSITY MEDICAL SERVICE ASSOCIATION INC | FL | Otolaryngology Physician (207Y00000X) |
United | 82378 | $11.38 | 1457765968 - SUMMER MOON | 593282073 - (FL) BAY DERMATOLOGY AND COSMETIC SURGERY, P.A. | FL | Dermatology Physician (207N00000X) |
United | 82378 | $14.72 | 1508245531 - JONAH WHITE | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
United | 82378 | $9.39 | 1104002054 - WAMBURA MKONO | 461448783 - (FL) PULMONARY CC LLC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 82378 | $11.60 | 1205894169 - RICHARD GREENE | 223115490 - RICHARD M. GREENE, MD, PC | FL | Dermatology Physician (207N00000X) |
United | 82378 | $21.79 | 1699027995 - ANNIE WAFER | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 82378 | $7.96 | 1386103281 - THOMAS BROWN | 592017524 - (FL) FIRST COAST DERMATOLOGY P A | FL | Dermatology Physician (207N00000X) |
United | 82378 | $6.63 | 1568867067 - CAROLYN J. AGRESTI, M.D. EAR, NOSE AND THROAT, INC | 471787456 - (FL) CAROLYN J AGRESTI MD EAR NOSE AND THROAT INC | FL | Otolaryngology Physician (207Y00000X) |
United | 82378 | $9.51 | 1346203304 - JOSE ALVAREZ | 650432710 - (FL) WEST BROWARD PULMONARY CONSULTANTS PA | FL | Pulmonary Disease Physician (207RP1001X) |
United | 82378 | $7.96 | 1407207111 - SUN DERMATOLOGY LLC | 812652370 - (FL) SUN DERMATOLOGY LLC | FL | Dermatology Physician (207N00000X) |
United | 82378 | $15.50 | 1396903696 - ISWANTO SUCANDY | 462021581 - FLORIDA HOSPITAL PHYSICIAN GROUP INC | FL | Surgery Physician (208600000X) |
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 82378 vs. Other Pathology and Laboratory Procedures Codes
The CPT 82378 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 82378 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 |
|---|---|---|
| 82180-CPT | Low | Ascorbic Acid (Vitamin C), Blood |
| 82240-CPT | Low | Cholylglycine (Bile Acid) Test, A Bile Acid Test May Specifically Measure Cholylglycine. This Acid Is Useful As An Indicator Of Liver Injury From Cirrhosis Or Hiv. |
| 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. |
| 82378-CPT | Low | Cea (Tumor Marker) Test, This Test Measures The Level Of Cea (Carcinoembryonic Antigen) In The Body. This Is A Protein That May Be Found In Blood Or Other Body Fluids When A Tumor Is Present. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82378. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82378 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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