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See a sample rate comparisonCPT 84203 Fee Schedule
Last Verified: September 2026
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.
Test For Exposure To Lead, Test Of Whole Blood For The Amount Of Protoporphyrin For Diagnosis Of Various Anemias Or Lead Toxicity.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | None |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 84203 |
| Medicaid Fee Schedule | View Medicaid rates for 84203 |
National average reimbursement for CPT 84203 by major payers:
$8.11
$6.45
$9.87
$14.34
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CPT 84203
5 of 25 sample ratesHigher to lower in this preview
All Ways Homecare Inc
$55.00Published rateChristopher Raio
Mercy Medical Center
$12.86Published ratePrisma Health-Upstate, Prisma Health Transplant Center
Prisma Health - Upstate
$8.77Published rateChristopher Raio
St Francis Hospital
$5.84Published rateMark Vital
Hea Clinic, P.A., Dba Houston Eye Associates
$4.09Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 84203 vs. Other Chemistry Procedures Codes
The CPT 84203 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 84203 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 |
|---|---|---|
| 84202-CPT | Low | Test For Exposure To Lead, Test Of Whole Blood For The Amount Of Protoporphyrin For Diagnosis Of Various Anemias Or Lead Toxicity. |
| 84203-CPT | Low | Test For Exposure To Lead, Test Of Whole Blood For The Amount Of Protoporphyrin For Diagnosis Of Various Anemias Or Lead Toxicity. |
| 84260-CPT | Low | Serotonin Test, This Test Evaluates Either A Blood Or Spinal Fluid Sample For Serotonin. The Test Is Used To Help In Diagnosis Of Severe Depression Or Intestinal Tumors That Affect Serotonin Levels. |
| 84403-CPT | Low | Testosterone Hormone Test, Testosterone Helps Balance Male-Female Secondary Sex Characteristics Like Body Hair. Results Help Evaluate Pituitary Gland And Sex Gland Conditions. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84203. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84203 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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