CPT 84100 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 | • 21 - Inpatient Hospital • 81 - Independent Laboratory |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 84100 |
National average reimbursement for CPT 84100 by major payers:

$3.76

$3.37

$6.02

$6.81
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 84100 | ||||||
United | 84100 | $1.99 | 1598783326 - LESLIE STANWIX | 841337350 - (CO) SOUTHWEST HEALTH SYSTEM INC | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $1.99 | 1336535228 - STEPHANIE VANLANDINGHAM | 208753749 - (CO) AGEWELL MEDICAL ASSOCIATES, PC | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $2.71 | 1295227627 - GRETCHEN SONNENBERG | 840617567 - (CO) PEAK VISTA COMMUNITY HEALTH CENTERS | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $4.00 | 1477514388 - ALPHONSE GIORDANO | 111631746 - BROOKDALE HOSPITAL MEDICAL CENTER | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $2.13 | 1750442505 - LOBSS NETWORK SUPPORT 2002, CARENT LABORATORY SOLUTIONS | 481276150 | CO | Clinical Medical Laboratory (291U00000X) |
United | 84100 | $4.73 | 1316392152 - JONATHAN WALDMANN | 561732213 | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $6.50 | 1639149651 - ERIC OLSON | 841887834 | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $2.81 | 1104943976 - BIPIN KUMAR | 462989001 - (CO) HIMALAYA FAMILY MEDICINE CLINIC | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $6.50 | 1548262066 - JENNIFER BETTENHAUSEN | 841887834 | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $1.99 | 1831135300 - SHARRY VERES | 901116752 - (AZ) BANNER UNIVERSITY PRIMARY CARE PHYSICIANS LLC | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $2.77 | 1457649808 - MARY SHANNON BECKER | 841405295 - (CO) MOUNTAIN MEDICAL SPECIALISTS LLC | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $7.28 | 1366149734 - EASTERN RIO BLANCO COUNTY HEALTH SERVICE DISTRICT, COLORADO ADVANCED ORTHOPEDICS CLINIC | 870788731 - (CO) EASTERN RIO BLANCO COUNTY HEALTH SERVICE DISTRICT | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $6.50 | 1124291547 - RUTH OVERLEASE | 841887834 | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $4.73 | 1649298746 - ELIZABETH KELTS | 473325552 - (CO) PRIMARY CARE NPS INC | CO | Family Medicine Physician (207Q00000X) |
United | 84100 | $2.83 | 1972965549 - GRAY EDWARDS | 710689680 - MERCY HOSPITAL OZARK | CO | Family Medicine Physician (207Q00000X) |
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 84100 vs. Other Chemistry Procedures Codes
The CPT 84100 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 84100 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84100 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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