CPT 82495 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 | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 82495 |
| Medicaid Fee Schedule | View Medicaid rates for 82495 |
National average reimbursement for CPT 82495 by major payers:
$17.61
$13.46
$22.31
$29.64
CPT 82495 vs. Other Chemistry Procedures Codes
The CPT 82495 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 82495 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 |
|---|---|---|
| 82441-CPT | Low | Pesticide Exposure Test, The Test Looks For Chlorinated Hydrocarbons Which Are Used Commonly In Pesticides. Their Presence In High Numbers Is A Confirmation Of Toxic Exposure. They Can Affect The Health Of The Nervous System. |
| 82485-CPT | Low | Test For Dermatan Sulfate, Dermatan Sulfate (Chondroitin B Sulfate) Is Found In The Skin Blood Vessels And Valves Tendons And Lungs. It Belongs To A Group Of Substances That Play An Important Role In Carbohydrate Digestion. The Test Indicates Whether Amounts Are Out Of Balance. |
| 82495-CPT | Low | Chromium |
| 82525-CPT | Low | Copper Test, This Test Checks A Sample Of Blood Or Urine For Copper A Mineral Needed In Very Small Amounts To Make Red Blood Cells. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82495. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82495 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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