CPT 82415 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 |
| Common Modifiers | None |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 82415 |
National average reimbursement for CPT 82415 by major payers:
$11.47
$9.10
$14.09
$19.22
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 82415 | $12.67 | 1629021845 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, NORTH AUSTIN MEDICAL CENTER | 742781812 | TX | General Acute Care Hospital (282N00000X) |
United | 82415 | $6.84 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 82415 | $15.19 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 82415 | $12.67 | 1417471467 - WEATHERFORD HEALTH SERVICES, LLC, MEDICAL CITY WEATHERFORD | 822073410 - (TX) WEATHERFORD HEALTH SERVICES LLC | TX | General Acute Care Hospital (282N00000X) |
United | 82415 | $45.00 | 1205189172 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL OVERLOOK | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 82415 | $15.19 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 82415 | $16.08 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 82415 | $12.67 | 1427472463 - RESOLUTE HOSPITAL COMPANY, LLC, RESOLUTE HEALTH HOSPITAL | 462942963 - (TX) RESOLUTE HOSPITAL COMPANY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 82415 | $12.67 | 1912943184 - WOMAN'S HOSPITAL FOUNDATION, WOMAN'S HOSPITAL | 720652905 - (LA) WOMANS HOSPITAL FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 82415 | $21.23 | 1972517365 - COVENANT MEDICAL CENTER | 822913146 - (TX) COVENANT MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 82415 | $9.45 | 1053391094 - ASYA SEGALENE | 362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C. | IL | Allergy Physician (207KA0200X) |
United | 82415 | $15.56 | 1104819366 - CHILDREN'S HOSPITAL | 720467503 - CHILDRENS HOSPITAL INC | LA | Children's Hospital (282NC2000X) |
United | 82415 | $15.05 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 82415 | $7.42 | 1356320873 - EAST TEXAS MEDICAL CENTER ATHENS | 751854562 - (TX) ETX SUCCESSOR ATHENS | TX | General Acute Care Hospital (282N00000X) |
United | 82415 | $23.45 | 1659559573 - ST LUKES COMMUNITY DEVELOPMENT CORPORATION, ST LUKES SUGAR LAND HOSPITAL | 261947374 - (TX) ST LUKES COMMUNITY DEVELOPMENT CORPORATION-SUGAR LAND | TX | General Acute Care Hospital (282N00000X) |
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 82415 vs. Other Pathology and Laboratory Procedures Codes
The CPT 82415 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 82415 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. |
| 82435-CPT | Low | Chloride Electrolyte Test, This Test Checks A Blood Sample For Chloride. This Is One Of The Cell Salts Essential For Maintaining The Bodys Electrolyte Balance. Typically Chloride Is Absorbed From Table Salt. |
| 82436-CPT | Low | Chloride Electrolyte Test, This Test Checks A Urine Sample For Chloride. This Is One Of The Cell Salts Essential For Maintaining The Bodys Electrolyte Balance. Typically Chloride Is Absorbed From Table Salt. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82415. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82415 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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