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 83864 Fee Schedule
Medicare rates as of January 2026
CPT 83864 is classified under Pathology and Laboratory Procedures, in the Chemistry Procedures subgroup.
Test For Metabolic Condition, The Test Detects A Group Of Substances Called Glycosaminoglycans. These Are Important For Digesting Carbohydrates. They Also Are Found In Connective Tissue.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory Q4 - Service for ordering / referring physician qualifies as a service exemption for laboratory services |
| Complexity Level | Low |
| Medicare Fee Schedule | $28.50 national lab fee schedule rate (2026) · View Medicare rates for 83864 |
| Medicaid Fee Schedule | $26.22 median of the 8 states in the free preview · View Medicaid rates for 83864 |
National average reimbursement for CPT 83864 by major payers:
$22.24
BCBS / Anthem
$16.73
UnitedHealthcare
$28.91
Aetna
$39.80
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 83864.
CPT 83864
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$62.70Published rateTitus County Hospital District, Titus Regional Medical Center
$34.20Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$28.50Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$21.95Published rateAaron Askew
Desert Bone & Joint Specialists, LLP
$11.39Published 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 83864 vs. Other Chemistry Procedures Codes
The table lists codes related to 83864. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 83835-CPT | Low | Stress Hormone Test, This Test For Stress Hormones Can Help Identify Whether Symptoms Are Related To Severe Stress Or An Adrenal Gland Tumor. |
| 83857-CPT | Low | Blood Protein Test, This Blood Protein Test Checks For Methemalbumin. It Is Present In The Blood When An Illness Or Disease Process Is Destroying Red Blood Cells. |
| 83864-CPT | Low | Test For Metabolic Condition, The Test Detects A Group Of Substances Called Glycosaminoglycans. These Are Important For Digesting Carbohydrates. They Also Are Found In Connective Tissue. |
| 83872-CPT | Low | Joint Fluid Test, Fluid From A Joint (Synovial Fluid) Is Mixed With A Chemical To Find Out If It Clumps Together. The Test Is Used To Evaluate The Possibility Of An Inflammatory Joint Condition. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83864. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83864 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 83864) and we'll show you how you compare in 15 minutes or less.