Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 83516 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.
Immunoassay For Analyte Other, Immunoassay For Analyte Other Than Infectious Agent Antibody Or Infectious Agent Antigen Qualitative Or Semiquantitative Multiple Step Method
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | QW - CLIA Waived Tests 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $11.53 national lab fee schedule rate (2026) · View Medicare rates for 83516 |
| Medicaid Fee Schedule | $10.62 median of the 8 states in the free preview · View Medicaid rates for 83516 |
National average reimbursement for CPT 83516 by major payers:
$9.83
$15.32
$13.77
$16.78
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 83516.
CPT 83516
5 of 25 sample ratesHigher to lower in this preview
Benjamin Nulsen
$47.00Published rateMary Thomas
Northwell Healthcare Inc
$12.17Published ratePeter Francisco
Mary Imogene Bassett Hospital
$8.30Published rateDiahann Seaman
Physician Affiliate Group Of New York PC
$5.36Published rateIlya Badalov
Digestive Disease Care, PC
$4.84Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 83516 vs. Other Chemistry Procedures Codes
The CPT 83516 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 83516 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 |
|---|---|---|
| 83516-CPT | Low | Immunoassay For Analyte Other, Immunoassay For Analyte Other Than Infectious Agent Antibody Or Infectious Agent Antigen Qualitative Or Semiquantitative Multiple Step Method |
| 83518-CPT | Low | Immunoassay For Analyte Other, Immunoassay For Analyte Other Than Infectious Agent Antibody Or Infectious Agent Antigen Qualitative Or Semiquantitative Single Step Method (Eg Reagent Strip) |
| 83519-CPT | Low | Immunoassay For Analyte Other, Immunoassay For Analyte Other Than Infectious Agent Antibody Or Infectious Agent Antigen Quantitative By Radioimmunoassay (Eg Ria) |
| 83520-CPT | Low | Immunoassay Analyte Quantita, Immunoassay Analyte Quantitative Not Otherwise Specified (Closest Clinically Equivalent Code(S) Deleted In 1993 84231) (Closest Clinically Equivalent Code(S) Deleted In |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83516. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83516 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 83516) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
CPT 83516 reports an immunoassay for an analyte other than an infectious agent antibody or antigen, qualitative or semiquantitative, using a multiple-step method.
It is generally reported once per analyte tested, so a panel of several analytes can carry multiple units. Payers often limit units, so check medically unlikely edits and payer policy.
Medicare pays CPT 83516 under the Clinical Laboratory Fee Schedule, a single national rate based on what private payers paid labs, rather than under the Physician Fee Schedule. Commercial lab rates are negotiated separately and vary widely by payer and by whether the test is run by an independent lab, a hospital outpatient lab or a physician office lab.
This page lists the rates commercial payers have published for CPT 83516 in their Transparency in Coverage files, so you can compare payers and see where a contract falls. For government benchmarks, PayerPrice also has the Medicare fee schedule lookup and Medicaid fee schedules by state.