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See a sample rate comparisonCPT 83069 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | QW - CLIA Waived Tests 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $3.95 national lab fee schedule rate (2026) · View Medicare rates for 83069 |
| Medicaid Fee Schedule | $3.635 median of the 8 states in the free preview · View Medicaid rates for 83069 |
National average reimbursement for CPT 83069 by major payers:
$3.53
$2.79
$5.12
$5.78
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CPT 83069
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$8.69Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$5.21Published rateColumbia Medical Center Of Plano Subsidiary Lp, Medical City Plano
$3.95Published rateCharleston Radiologists PA
Charleston Radiologists, P.A.
$2.88Published rateBrittany Ptachick
Hroa 401k Plan
$1.66Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 83069 vs. Other Chemistry Procedures Codes
The CPT 83069 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 83069 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 |
|---|---|---|
| 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. |
| 83068-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 83069. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83069 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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