CPT 83605 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 | Chemistry Procedures Pathology and Laboratory Procedures |
| Common Place of Service | 21 - Inpatient Hospital 23 - Emergency Room |
| Common Modifiers | None 26 - Professional component 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 83605 |
National average reimbursement for CPT 83605 by major payers:

$9.95

$7.84

$13.27

$17.02
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 83605 | $5.90 | 1588033831 - NICOLE DRAGO | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Nurse Practitioner (363L00000X) |
United | 83605 | $6.94 | 1497118087 - ALEXANDER LAZARIDES | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Orthopaedic Surgery Physician (207X00000X) |
United | 83605 | $4.86 | 1912042342 - RENAL CONSULTANTS MEDICAL GROUP | 953841576 - (CA) RENAL CONSULTANTS MEDICAL GROUP | CA | Nephrology Physician (207RN0300X) |
United | 83605 | $5.90 | 1649037680 - ISABEL CANIZARES | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Family Nurse Practitioner (363LF0000X) |
United | 83605 | $5.90 | 1255871729 - CRYSTAL ERHARDT | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 83605 | $5.90 | 1154822401 - ELIZABETH FINLEY-OLIVER | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Nurse Practitioner (363L00000X) |
United | 83605 | $6.94 | 1407944283 - SMITHA PABBATHI | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Internal Medicine Physician (207R00000X) |
United | 83605 | $15.86 | 1861468431 - TIZIANA CALIFANO | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Internal Medicine Physician (207R00000X) |
United | 83605 | $5.90 | 1629317276 - NATALIE LINCOLN | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 83605 | $5.90 | 1750687018 - ROSEMARY PANAVELIL | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 83605 | $5.90 | 1821457342 - AMBER VAZQUEZ | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Family Nurse Practitioner (363LF0000X) |
United | 83605 | $5.90 | 1992585723 - MELISSA GANT | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Family Nurse Practitioner (363LF0000X) |
United | 83605 | $5.90 | 1760013510 - HOPE HAHL | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Family Nurse Practitioner (363LF0000X) |
United | 83605 | $5.90 | 1578268751 - BRET BELTER | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 83605 | $6.94 | 1497945695 - FARAH KHALIL | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Anatomic Pathology & Clinical Pathology Physician (207ZP0102X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 83605 vs. Other Pathology and Laboratory Procedures Codes
The CPT 83605 code is part of the Chemistry Procedures services used for Pathology and Laboratory 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 83605 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 |
|---|---|---|
| 83605-CPT | Low | Test For Lactic Acid Buildup, This Test Takes A Blood Or Spinal Fluid Sample. Too Much Lactic Acid Can Starve Tissues Of Oxygen. Lactic Acid Can Build Up In Muscles When They Are Exercised. |
| 83615-CPT | Low | Test For Tissue Damage, This Test Measures The Enzyme Lactic Dehydrogenase (Ldh) To Check For And Assess Tissue Damage Particularly After A Stroke Or Heart Attack. |
| 83625-CPT | Low | Test For Tissue Damage, This Test Measures The Enzyme Lactic Dehydrogenase (Ldh) To Check For And Assess Tissue Damage Particularly After A Stroke Or Heart Attack. |
| 83690-CPT | Low | Lipase Enzyme Blood Test, This Test Measures The Amount Of Lipase Present In A Blood Sample. Lipase Is A Digestive Enzyme Made By The Pancreas. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83605. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83605 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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