CPT 83918 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 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 83918 |
| Medicaid Fee Schedule | View Medicaid rates for 83918 |
National average reimbursement for CPT 83918 by major payers:
$18.76
$14.30
$26.71
$33.57
CPT 83918 vs. Other Chemistry Procedures Codes
The CPT 83918 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 83918 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 |
|---|---|---|
| 83789-CPT | Low | Mass Spectrometry Qual Quan, Mass Spectrometry And Tandem Mass Spectrometry Eg Ms Ms Ms Maldi Ms Tof Qtof Non Drug Analyte S Not Elsewhere Specified Qualitative Or Quantitative Each Specimen |
| 83918-CPT | Low | Testing For Organic Acids, The Test Measures The Quantity Of An Organic Acid (Such As Fatty Acids Sugars Yeasts And Bacteria) In A Urine Sample. |
| 83921-CPT | Low | Testing For Organic Acids, The Test Measures The Quantity Of An Organic Acid (Such As Fatty Acids Sugars Yeasts And Bacteria) In A Urine Sample. |
| 83930-CPT | Low | Test Of Blood Density, Test To Measure The Density Of Particles In The Blood Which Are Responsible For Retaining Or Secreting Water From The Body. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83918. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83918 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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