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See a sample rate comparisonCPT 84035 Fee Schedule
Medicare rates as of January 2026
CPT 84035 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 | 11 - Office |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $3.98 national lab fee schedule rate (2026) · View Medicare rates for 84035 |
| Medicaid Fee Schedule | $3.69 median of the 8 states in the free preview · View Medicaid rates for 84035 |
National average reimbursement for CPT 84035 by major payers:
$3.46
BCBS / Anthem
$2.75
UnitedHealthcare
$4.25
Aetna
$5.76
Cigna
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CPT 84035
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
St Francis Hospital
$5.25Published rateProvidence Hospital, LLC, Providence Health
Medical University Hospital Authority
$3.98Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Seneca
Prisma Health - Upstate
$3.57Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$2.39Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$1.38Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 84035 vs. Other Chemistry Procedures Codes
The table lists codes related to 84035. 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 84035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84035 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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