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See a sample rate comparisonCPT 82963 Fee Schedule
Last Verified: October 2026
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.
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| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $21.48 national lab fee schedule rate (2026) · View Medicare rates for 82963 |
| Medicaid Fee Schedule | $21.21 median of the 8 states in the free preview · View Medicaid rates for 82963 |
National average reimbursement for CPT 82963 by major payers:
$19.04
$14.91
$26.57
$31.07
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CPT 82963
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$47.26Published rateTenet Hospitals Limited, The Hospitals Of Providence Sierra Campus
$21.47Published ratePrisma Health-Upstate, Prisma Health Int Med/Subspec Clinic
Prisma Health - Upstate
$19.32Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$12.89Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$7.51Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 82963 vs. Other Chemistry Procedures Codes
The CPT 82963 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 82963 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 |
|---|---|---|
| 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. |
| 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. |
| 82941-CPT | Low | Stomach Acid Test, Gastrin Is A Hormone That Regulates Stomach Acid Secretion. This Test Measures The Amount Of Gastrin In A Blood Sample. |
| 82963-CPT | Low | Test For Gaucher Disease, Gaucher Disease Is A Genetic Disorder Affecting The Ability Of A Cellular Subunit (Lysosome) To Store Digestive Enzymes. There Are Several Variations Of Gaucher That Can Affect The Liver Spleen Or Nervous System Functions. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 82963. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 82963 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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