Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 84165 Fee Schedule
Medicare rates as of January 2026
CPT 84165 is classified under Pathology and Laboratory Procedures, in the Chemistry Procedures subgroup.
Protein Pattern Test, Proteins Are Found In Blood Urine And Spinal Fluid. The Distribution Of Those Proteins -- Their Patterns -- Give Clues That Aid Diagnosis.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $10.74 national lab fee schedule rate (2026) · View Medicare rates for 84165 |
| Medicaid Fee Schedule | $10.74 median of the 8 states in the free preview · View Medicaid rates for 84165 |
National average reimbursement for CPT 84165 by major payers:
$14.34
BCBS / Anthem
$7.84
UnitedHealthcare
$14.11
Aetna
$24.18
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 84165.
CPT 84165
5 of 25 sample ratesHigher to lower in this preview
Baycare Home Care, Inc.
Baycare Home Care Inc
$10.85Published rateSunil Saini
Head And Neck Associates Of Orange County, Inc.
$6.30Published rateJacquelyn Hunter
Head And Neck Associates Of Orange County, Inc.
$6.30Published rateGeeta Venkat
Head And Neck Associates Of Orange County, Inc.
$6.30Published rateNakayae Norton
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$5.48Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 84165 vs. Other Chemistry Procedures Codes
The table lists codes related to 84165. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 84134-CPT | Low | Malnutrition Testing, The Test Measures Prealbumin A Protein Related To Malnutrition. Large Amounts Of Prealbumin Usually Indicate An Imbalance. |
| 84155-CPT | Low | Total Blood Protein Test, The Total Blood Protein Test Measures The Amount Of Proteins Present In A Blood Sample. Typically These Are Proteins Made By The Liver Or Immune System. |
| 84156-CPT | Low | Total Urine Protein Test, The Total Urine Protein Test Helps To Assess Kidney Health By Measuring The Level Of Protein Present In The Kidneys. |
| 84165-CPT | Low | Protein Pattern Test, Proteins Are Found In Blood Urine And Spinal Fluid. The Distribution Of Those Proteins -- Their Patterns -- Give Clues That Aid Diagnosis. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84165. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84165 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 84165) and we'll show you how you compare in 15 minutes or less.