CPT 82726 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 91 - Repeat Lab Test 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 82726 |
| Medicaid Fee Schedule | View Medicaid rates for 82726 |
National average reimbursement for CPT 82726 by major payers:
$16.72
$13.14
$20.05
$28.64
CPT 82726 vs. Other Chemistry Procedures Codes
The CPT 82726 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 82726 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 |
|---|---|---|
| 82725-CPT | Low | Fatty Acid Blood Test, This Test Specifically Measures Nonesterified Fatty Acids (Nefa) In A Blood Sample. These Are Fatty Acids That Have Not Attached To Enzymes Or Other Substances. |
| 82726-CPT | Low | Nerve Condition Blood Test, This Blood Test Evaluates Very Long Chain Fatty Acids (Vlcfa). It Is Used To Identify Diseases That Involve Degeneration Of Nerve Tissues And Loss Of Muscle Control. |
| 82735-CPT | Low | Fluoride Testing, The Fluoride Test Checks For Toxic Levels. Excess May Accumulate From Overuse Of Dietary Supplements As Well As Exposure To Insecticides Or Industrial Salts. |
| 82746-CPT | Low | Folic Acid Blood Test, Folic Acid Is A B Vitamin. It Affects Red Blood Cell (Rbc) Health And The Ability To Absorb And Retain Iron. Tests Measure The Total Amount Of Folic Acid In The Blood Or The Amount In Rbcs. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82726. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82726 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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