CPT 83065 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 21 - Inpatient Hospital |
| Common Modifiers | None 91 - Repeat Lab Test 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 83065 |
| Medicaid Fee Schedule | View Medicaid rates for 83065 |
National average reimbursement for CPT 83065 by major payers:
$7.35
$5.32
$8.98
$12.64
CPT 83065 vs. Other Chemistry Procedures Codes
The CPT 83065 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 83065 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 |
|---|---|---|
| 83060-CPT | Low | Reduced Blood Oxygen Test, The Test Examines A Blood Sample For Sulfhemoglobin. This Is A Substance Created By The Blood In Response To Certain Medicines. Sulfhemoglobin Makes Red Blood Cells Unable To Carry Oxygen And Can Result In Bluish-Colored Skin. |
| 83065-CPT | Low | Test For Unstable Hemoglobin, This Blood Test Evaluates The Sample For Hemoglobin That Breaks Down Too Quickly. The Condition Can Produce Symptoms Similar To Anemia. Unstable Hemoglobin May Also Be Produced During An Infection. |
| 83069-CPT | Low | Blood Oxygen Capacity Test, Blood Or Urine Is Tested For Hemoglobin (Hb) A Protein That Carries Oxygen In Red Blood Cells. Excessive Amounts Of The Various Types Of Hb Are Linked To Anemia And Premature Cell Death. |
| 83080-CPT | Low | Tay-Sachs (Enzyme) Test, Test For A Rare Genetic Enzyme (Hexosaminidase) Deficiency That Prevents Breakdown Of Fatty Acids. Fats Are Stored In The Brain And Nerves Progressively Damaging The Central Nervous System. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83065 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 83065) and we'll show you how you compare in 15 minutes or less.