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See a sample rate comparisonCPT 83520 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 Analyte Quantita, Immunoassay Analyte Quantitative Not Otherwise Specified (Closest Clinically Equivalent Code(S) Deleted In 1993 84231) (Closest Clinically Equivalent Code(S) Deleted In
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $17.27 national lab fee schedule rate (2026) · View Medicare rates for 83520 |
| Medicaid Fee Schedule | $17.055 median of the 8 states in the free preview · View Medicaid rates for 83520 |
National average reimbursement for CPT 83520 by major payers:
$14.39
$11.55
$18.77
$24.27
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CPT 83520
5 of 25 sample ratesHigher to lower in this preview
Brooke Henschel
The Neuroscience Group Of Northeast Wisconsin Sc
$42.54Published rateSumon Bhattacharjee
The Neuroscience Group Of Northeast Wisconsin Sc
$42.54Published rateMichelle Ziegelbauer
The Neuroscience Group Of Northeast Wisconsin Sc
$42.54Published rateRalph Lott
Slocum Dickson Medical Group PLLC
$19.86Published rateMiguel Arenas
Miguel A Arenas Md PC
$7.25Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 83520 vs. Other Chemistry Procedures Codes
The CPT 83520 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 83520 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 83520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83520 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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized numerical codes used by healthcare providers, insurers, and government agencies to describe medical, surgical, and diagnostic services and procedures. They are crucial for accurate billing, processing insurance claims, and tracking healthcare services.
The cost of medical procedures can vary significantly based on your insurance plan, location, and the specific healthcare provider. To find an estimated cost, you can contact your insurance provider directly, as they can provide information on what your plan covers and your out-of-pocket expenses. You can also reach out to the billing department of the healthcare facility or provider for an estimate. For a more direct way to look up costs based on CPT codes and specific locations, consider using a specialized tool like Payerprice.
A fee schedule in healthcare is a comprehensive list of fees used by insurance companies, government programs (like Medicare), and other payers to reimburse healthcare providers for various medical services and procedures. Each service, identified by a CPT code, has an associated fee. Fee schedules help standardize payment rates and provide a basis for how much providers will be paid for their services.
To find fee schedules for specific CPT codes relevant to your geographic location, you can use dedicated online tools. I recommend using Payerprice, which offers a fee schedule lookup tool allowing users to search with CPT codes and specific locations to get accurate pricing information. This tool helps in understanding the reimbursement rates for various medical services.
CMS, the Centers for Medicare & Medicaid Services, plays a significant role in healthcare pricing primarily by administering Medicare and Medicaid programs. They establish national fee schedules and reimbursement policies for services covered under these government programs. While CMS fee schedules are publicly available and can influence broader market rates, for individuals looking for fee schedules for *all* payers or specific commercial insurance rates based on their unique situation and location, tools like Payerprice are more directly applicable and comprehensive.