CPT 82820 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 | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None 91 - Repeat Lab Test 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 82820 |
| Medicaid Fee Schedule | View Medicaid rates for 82820 |
National average reimbursement for CPT 82820 by major payers:
$11.01
$11.62
$13.38
$19.05
CPT 82820 vs. Other Chemistry Procedures Codes
The CPT 82820 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 82820 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 |
|---|---|---|
| 82759-CPT | Low | Milk Sugar Digestion Test, This Blood Test Identifies A Deficiency Of Galactokinase An Enzyme Needed To Digest Milk Sugars. A Deficiency Is Related To Lactose Intolerance In Infants. |
| 82810-CPT | Low | Measure Of Blood Oxygen Level, Measurement Of Oxygen Saturation In The Blood. A Low Result Indicates That Oxygen Is Not Reaching Organs Or That The Blood Is Not Able To Transport Enough Oxygen Around The Body. |
| 82820-CPT | Low | Hemoglobin-Oxygen Binding Test, The Hemoglobin-Oxygen Binding Test Measures How Well Hemoglobin Can Bind With Oxygen. If The Two Substances Do Not Combine Well Organs And Other Tissues May Be Starved Of The Oxygen They Need. |
| 82930-CPT | Low | Stomach Acid Test, The Stomach (Gastric) Acid Test Evaluates Secretion Of Hydrochloric Acid Which Is Essential For This Stage Of Digestion. Conditions Such As Pernicious Anemia And Peptic Ulcers Can Greatly Affect Stomach Acid Secretion. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82820 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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