CPT 83009 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 | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | None QW - CLIA Waived Tests PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 83009 |
| Medicaid Fee Schedule | View Medicaid rates for 83009 |
National average reimbursement for CPT 83009 by major payers:
$58.15
$46.94
$68.74
$121.84
CPT 83009 vs. Other Chemistry Procedures Codes
The CPT 83009 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 83009 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 |
|---|---|---|
| 82977-CPT | Low | Bile Enzyme (Ggt) Test, Ggt (Gamma Glutamic Transpeptidase) Is An Enzyme Produced In The Bile Ducts. This Test Helps Screen For Liver Disease. |
| 83009-CPT | Low | Stomach Ulcer Bacteria Test, Helicobacter Pylori Can Cause Stomach Ulcers And Painful Inflammation. This Test Detects An Infection And Can Be Used To Monitor Response To Treatment. |
| 83013-CPT | Low | Digestive Bacteria Breath Test, Test That Analyzes Exhaled Breath After Taking A Urea Pill To Determine If Helicobacter Pylori (H. Pylori) Bacteria Is Present In The Digestive System. This Bacteria Can Cause Stomach Ache And Ulcers. |
| 83014-CPT | Low | Drug For Bacteria Test, The Test For Helicobacter Pylori (Bacteria Associated With Ulcers) Requires Taking A Drug With A Small Amount Of Radioactive Material Followed By A Breath Test. If The Bacteria Are Present The Pill Changes The Character Of The Breath. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83009. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83009 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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