CPT 82397 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 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 82397 |
National average reimbursement for CPT 82397 by major payers:

$12.31

$17.40

$16.65

$20.60
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 82397 | $21.39 | 1134217078 - MOSHE RUBIN | 111839362 - NEWYORK-PRESBYTERIAN-QUEENS | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $6.53 | 1184672149 - CARL MCDOUGALL | 810608606 | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $6.34 | 1063776771 - TAREK ALANSARI | 320442710 | IL | Gastroenterology Physician (207RG0100X) |
United | 82397 | $9.64 | 1548275944 - ALBERT ATTIA | 134002911 - (NY) SLR FPP UNIVERSITY MEDICAL PRACTICE ASSOCIATES | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $5.65 | 1134577166 - NICOLAS PATEL | 223376459 - HACKENSACK MERIDIAN HEALTH MEDICAL GROUP-SPECIALTY CARE PC | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $8.47 | 1255573671 - ASHLEY MARANINO | 134185781 - SJR MEDICAL PC | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $8.47 | 1487711743 - JONATHAN HUANG | 166198245 - (NY) GASTROINTESTINAL GROUP | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $8.47 | 1659311074 - VIVEK KAUL | 160743037 - (NY) HIGHLAND HOSPITAL OF ROCHESTER | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $6.53 | 1801895248 - TIMOTHY JOHNSON | 454176686 - (NY) URBAN MEDICAL GROUP PLLC | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $8.47 | 1750315628 - GABRIEL IONESCU | 133779481 - (NY) HOUSING WORKS SERVICES INC | AL | Gastroenterology Physician (207RG0100X) |
United | 82397 | $6.34 | 1710040860 - GEORGE JHAGROO | 1710040860 - (NY) GEORGE JHAGROO | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $5.03 | 1386673424 - BORA GUMUSTOP | 113466729 - (NY) GASTROINTESTINAL CARE OF LONG IS | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $28.55 | 1770696197 - ROBERT CHATALBASH | 453023019 - (NY) NORTH SHORE-LIJ MEDICAL PC | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $5.92 | 1164426987 - LOUIS MAY | 113466729 - (NY) GASTROINTESTINAL CARE OF LONG IS | NY | Gastroenterology Physician (207RG0100X) |
United | 82397 | $5.92 | 1538229984 - SYED HUSSAIN | 274356726 | NY | Gastroenterology Physician (207RG0100X) |
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 82397 vs. Other Pathology and Laboratory Procedures Codes
The CPT 82397 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 82397 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 |
|---|---|---|
| 82397-CPT | Low | Chemistry Test For Substance, The Chemiluminescence Test Method Mixes Two Chemicals Together And Evaluates The Light Produced By The Mix. The Test Is Used To Identify Substances And Measure Their Amount In The Sample Being Tested. |
| 82415-CPT | Low | Antibiotic Monitoring, Lab Blood Test To Ensure Therapeutic Levels Of An Antibiotic. Monitoring Ensures Levels Are High Enough To Treat The Infection But Low Enough To Avoid Toxicity. |
| 82523-CPT | Low | Collagen Cross-Link Test, This Test Evaluates Collagen For Cross-Links. This Indicates The Health Of Bone Structure And Bone Creation. It Is Related To Parathyroid Gland Function And Osteoporosis. |
| 82530-CPT | Low | Cortisol Hormone Test, This Test Screens For Cushings Syndrome (Too Much Cortisol) And Addisons Disease (Too Little Cortisol). Cortisol Is A Hormone That Plays A Major Role In The Bodys Stress Response. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82397. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82397 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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