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See a sample rate comparisonCPT 84030 Fee Schedule
Medicare rates as of January 2026
CPT 84030 is classified under Pathology and Laboratory Procedures, in the Chemistry Procedures subgroup.
Newborn Pku Screen, The Pku Screen Identifies An Inherited Condition That Damages The Central Nervous System And Brain. All Newborns Are Screened For A Critical Enzyme Used To Digest Amino Acids From Foods Containing Proteins.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | 26 - Professional component QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | $5.50 national lab fee schedule rate (2026) · View Medicare rates for 84030 |
| Medicaid Fee Schedule | $5.06 median of the 8 states in the free preview · View Medicaid rates for 84030 |
National average reimbursement for CPT 84030 by major payers:
$4.85
BCBS / Anthem
$8.98
UnitedHealthcare
$6.32
Aetna
$8.38
Cigna
Compare published rates across providers.
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CPT 84030
5 of 25 sample ratesHigher to lower in this preview
Helen A Preston Md PA, Comprehensive Heart And Sleep
$33.00Published rateChandrakant Patel
$3.30Published rateLuis Tami
$2.63Published rateVincent Siebert
$2.11Published ratePremier Cardiology Of Vero Beach
$1.92Published rate
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See a sample payer proposalCPT 84030 vs. Other Chemistry Procedures Codes
The table lists codes related to 84030. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 84030-CPT | Low | Newborn Pku Screen, The Pku Screen Identifies An Inherited Condition That Damages The Central Nervous System And Brain. All Newborns Are Screened For A Critical Enzyme Used To Digest Amino Acids From Foods Containing Proteins. |
| 84035-CPT | Low | Newborn Pku Screen, The Pku Screen Identifies An Inherited Condition That Damages The Central Nervous System And Brain. All Newborns Are Screened For A Critical Enzyme Used To Digest Amino Acids From Foods Containing Proteins. |
| 84105-CPT | Low | Phosphorus Trace Element Test, The Urine Phosphorus Test Checks For Calcium Absorption And Kidney Function. Phosphorus Is A Trace Element Required For Proper Digestion Bone Formation And Kidney Health. It Aids The Balance Of Calcium Potassium And Glucose. |
| 84132-CPT | Low | Potassium Electrolyte Test, Potassium Is An Electrolyte Critical For Heart And Skeletal Muscles. The Blood Test Measures Overall Potassium. The Urine Test Verifies High Levels Related To Kidney Disease. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84030. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84030 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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