CPT 83950 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 21 - Inpatient Hospital |
| Common Modifiers | None 90 - Reference Laboratory 26 - Professional component Q1 - Routine clinical service provided in a clinical research study |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 83950 |
National average reimbursement for CPT 83950 by major payers:
$54.51
$45.57
$70.60
$94.58
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 83950 | $27.04 | 1942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY | 741282696 - ST JOSEPH REGIONAL HEALTH CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 83950 | $64.41 | 1679528889 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER | 742781812 | TX | General Acute Care Hospital (282N00000X) |
United | 83950 | $76.52 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 83950 | $60.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 83950 | $35.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 83950 | $86.22 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 83950 | $77.29 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 83950 | $38.65 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 83950 | $36.81 | 1265446025 - MATTHEW KNECHT | 134352061 | OR | Optometrist (152W00000X) |
United | 83950 | $37.79 | 1275581852 - ROLLING PLAINS MEMORIAL HOSPITAL | 756003896 - (TX) THE NOLAN COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 83950 | $33.40 | 1740453000 - GRAHAM REGIONAL MEDICAL CENTER, GRAHAM GENERAL HSOPITAL PHYSICIANS | 463113489 | TX | General Acute Care Hospital (282N00000X) |
United | 83950 | $141.70 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 83950 | $57.97 | 1720747496 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH TRANSPLANT CENTER | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 83950 | $76.52 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 83950 | $57.97 | 1437605532 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CENTER FOR PEDIATRIC MED | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
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 83950 vs. Other Chemistry Procedures Codes
The CPT 83950 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 83950 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 |
|---|---|---|
| 83937-CPT | Low | Bone Density Testing, Bone Density Testing May Measure The Amount Of A Protein Called Osteocalcin. This Protein Plays A Role In Both The Formation Of Bone And Maintaining Mineral Density Within It. |
| 83950-CPT | Low | Her-2/Neu Breast Cancer Test, This Test Analyzes Hormone Markers For The Likely Aggressiveness Of A Breast Cancer. The Test Also Can Help Predict How Well A Particular Therapy Will Work. |
| 83951-CPT | Low | Dcp Cancer Protein Test, This Test Analyzes The Hormone Marker Dcp (Des-Gamma-Carboxy-Prothrombin) For The Likely Aggressiveness Of A Cancer. The Test Also Can Help Predict How Well A Particular Therapy Will Work. |
| 84152-CPT | Low | Prostate Test (Psa), Prostate Specific Antigen (Psa) Tests Include: Complex Psa Which Attaches To A Protein And Is Easiest To Measure. Free Psa Helps Calculate The Relative Severity Of A Condition. Total Psa Helps Monitor Treatment After A Biopsy Or Prostate Removal. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83950. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83950 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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