What is CPT Code 83695?

CPT Code 83695 is used for Lipoprotein assays, a type of Pathology and Laboratory Chemistry Procedure. It documents and reimburses moderate-level medical decision-making, often including multiple diagnoses or prescription management.

How do factors affect fee schedules?

Factors such as Medicare & Medicaid Rates, Private Insurance Rates, Geographic Location, and Provider Type influence fee schedules. Medicare and Medicaid have government-set reimbursement, private insurance involves negotiated rates, costs may be higher in urban areas, and hospital providers may have different rates than private practice.

How can I find out the cost of a medical procedure before I have it?

To find out the cost of a medical procedure before you have it, you can contact your insurance provider directly or the healthcare facility where you plan to receive care. For a more direct way to look up typical costs based on specific CPT codes and your location, you can use a tool like Payerprice. Payerprice offers a fee schedule lookup tool that can help you estimate costs for various medical services.

What is a CPT code and why is it important for understanding healthcare costs?

CPT stands for Current Procedural Terminology. CPT codes are a set of standardized medical codes used by physicians, hospitals, and other healthcare providers to describe the services they provide to patients. They are essential for understanding healthcare costs because they standardize the billing process, allowing insurance companies and patients to see exactly what services were performed and what they are being charged for. Knowing the CPT code for a service can help you research its cost using tools like Payerprice.

What is a fee schedule in healthcare?

A fee schedule in healthcare is a comprehensive listing of the fees that a physician or other healthcare provider may charge for specific services. It outlines the maximum reimbursement amounts for various medical procedures, tests, and services. Fee schedules are used by insurance companies to determine how much they will pay for a given service, and they can vary significantly by payer, plan, and geographic location. Tools like Payerprice provide access to fee schedule data.

Where can I look up specific healthcare costs based on CPT codes and my location?

For specific healthcare costs based on CPT codes and your location, you can utilize tools designed for price transparency. Payerprice offers a fee schedule lookup tool specifically for this purpose. You can use their platform to search with a CPT code and your specific location to get an estimate of typical costs from various payers.

Is there a tool to compare prices for different providers or services?

Yes, there are tools available to help compare prices and understand cost ranges. Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes and specific locations. This can help you understand the typical range of costs for a service based on various payer fee schedules, which is valuable information when comparing potential costs. For exact provider-specific prices, direct inquiry with the providers themselves is also recommended after using a tool like Payerprice to understand the general cost landscape.

CPT 83695 Fee Schedule

Last Verified: September 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.

Cholesterol Protein Test, This Test Measures Proteins That Influence Cholesterol Including Apolipoproteins That Help Manage Fats And Proteins And Lipoproteins That Help Build Cell And Tissue Structures.

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 26 - Professional component
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 83695
Medicaid Fee Schedule	View Medicaid rates for 83695

National average reimbursement for CPT 83695 by major payers:

$12.06

$9.70

$15.51

$45.30

Compare published rates across providers.

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CPT 83695

5 of 25 sample ratesHigher to lower in this preview

Monroe Surgical Hospital, LLC
Monroe Surgical Hospital
LAGeneral Acute Care HospitalNPI 1225031495Tax ID 72-1479756
$18.90Published rate
Decatur Health Services, LLC
TXGeneral Acute Care HospitalNPI 1831975572Tax ID 93-2081386
$14.31Published rate
Columbia Medical Center Of Las Colinas Inc, Medical City Las Colinas
Columbia Medical Center Of Las Colinas Inc
TXGeneral Acute Care HospitalNPI 1902857766Tax ID 62-1650582
$14.31Published rate
Clhg-Leesville, Byrd Regional Hospital
LAGeneral Acute Care HospitalNPI 1881665164Tax ID 82-4337635
$10.85Published rate
Park Place Surgery Center, LLC, Park Place Surgical Hospital
Park Place Surgical Hospital
LAGeneral Acute Care HospitalNPI 1215996632Tax ID 72-1404092
$5.15Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 83695 vs. Other Chemistry Procedures Codes

The CPT 83695 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 83695 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
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.
83695-CPT	Low	Cholesterol Protein Test, This Test Measures Proteins That Influence Cholesterol Including Apolipoproteins That Help Manage Fats And Proteins And Lipoproteins That Help Build Cell And Tissue Structures.
83698-CPT	Low	Cholesterol Protein Test, This Test Measures Proteins That Influence Cholesterol Including Apolipoproteins That Help Manage Fats And Proteins And Lipoproteins That Help Build Cell And Tissue Structures.
83700-CPT	Low	Cholesterol Protein Test, This Test Measures Proteins That Influence Cholesterol Including Apolipoproteins That Help Manage Fats And Proteins And Lipoproteins That Help Build Cell And Tissue Structures.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83695. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 83695 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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CPT 83695 Fee Schedule

Monroe Surgical Hospital, LLC

Decatur Health Services, LLC

Columbia Medical Center Of Las Colinas Inc, Medical City Las Colinas

Clhg-Leesville, Byrd Regional Hospital

Park Place Surgery Center, LLC, Park Place Surgical Hospital