CPT 83528 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 | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory GA - Required ABN issued and on file |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 83528 |
| Medicaid Fee Schedule | View Medicaid rates for 83528 |
National average reimbursement for CPT 83528 by major payers:
$16.44
$13.04
$20.24
$28.30
CPT 83528 vs. Other Chemistry Procedures Codes
The CPT 83528 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 83528 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 |
|---|---|---|
| 83001-CPT | Low | Fertility Hormone Test, Fsh (Follicle-Stimulating Hormone) Is A Hormone Made In The Pituitary Gland That Stimulates Ova (Eggs) Or Sperm To Mature. The Test Checks Blood Or A 24-Hour Urine Sample. |
| 83525-CPT | Low | Test For Low Blood Sugar, This Test Measures The Total Amount Of Insulin In A Blood Sample. The Test Is Used To Identify The Cause Of Low Blood Sugar (Hypoglycemia). |
| 83527-CPT | Low | Test For Low Blood Sugar, This Test Measures The Total Amount Of Insulin In A Blood Sample. The Test Is Used To Identify The Cause Of Low Blood Sugar (Hypoglycemia). |
| 83528-CPT | Low | Vitamin B12 Usage Test, The Test For Vitamin B12 Absorption Detects A Protein Called Intrinsic Factor That Should Be Present In The Stomach. B12 Is Used By Every Cell In The Body And Is Especially Important For The Brain Nervous System And Blood. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83528. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83528 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 83528) and we'll show you how you compare in 15 minutes or less.