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CPT 84220 Fee Schedule

Last Verified: January 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.

Pyruvate Kinase
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Chemistry Procedures

Common Place of Service

81 - Independent Laboratory

11 - Office

Common Modifiers

None

90 - Reference Laboratory

TC - Technical component

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 84220

National average reimbursement for CPT 84220 by major payers:

bcbs

$8.35

uhc

$6.65

aetna

$11.79

cigna

$14.26

Preview provider-level rates for...
For billing codeCPT 84220
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 84220

United
84220$6.591811000177 - CHARLESTON RADIOLOGISTS PA570634747 - CHARLESTON RADIOLOGISTS, P.A.SCSingle Specialty Group (193400000X)
United
84220$8.501467496802 - ST FRANCIS HOSPITAL, INC., ST. FRANCIS EASTSIDE582504530 - (SC) ST FRANCIS HOSPITAL INCSCGeneral Acute Care Hospital (282N00000X)
United
84220$5.401093783391 - CHRISTUS SPOHN HEALTH SYSTEM CORPORATION, CHRISTUS SPOHN HOSPITAL KLEBERG760422435 - C H WILKINSON PHYSICIAN NETWORKTXGeneral Acute Care Hospital (282N00000X)
United
84220$5.531235177320 - BIENVILLE MEDICAL CENTER, INC.743227578LACritical Access Hospital (282NC0060X)
United
84220$9.431396129201 - UNION MEDICAL CENTER, UNION MEDICAL CENTER474491361SCGeneral Acute Care Hospital (282N00000X)
United
84220$8.021235685892 - FAIRFIELD HOSPITAL DISTRICT, FREESTONE MEDICAL CENTER741774669TXGeneral Acute Care Hospital (282N00000X)
United
84220$13.181922058569 - SAN ANTONIO VAMC742112082TXGeneral Acute Care Hospital (282N00000X)
United
84220$9.431871911016 - NORTH TEXAS, MEDICAL CITY ALLIANCE464027347 - (TX) NORTH TEXASTXGeneral Acute Care Hospital (282N00000X)
United
84220$11.211255478004 - CHRISTOPHER RAIO113438973 - ST JOSEPH HOSPITALNYEmergency Medicine Physician (207P00000X)
United
84220$20.771073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
84220$22.501538667035 - CARTHAGE HOSPITAL, LLC824005981TXGeneral Acute Care Hospital (282N00000X)
United
84220$5.281821081720 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
84220$12.461255478004 - CHRISTOPHER RAIO113438973 - ST JOSEPH HOSPITALNYEmergency Medicine Physician (207P00000X)
United
84220$22.501205189172 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL OVERLOOK452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
84220$3.961740273994 - ECTOR COUNTY HOSPITAL DISTRICT, MEDICAL CENTER HOSPITAL752302928TXGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 84220 vs. Other Chemistry Procedures Codes

The CPT 84220 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 84220 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.

CodeComplexityDescription
84206-CPTLowProinsulin
84210-CPTLowPyruvate, Blood
84220-CPTLowPyruvate Kinase
84260-CPTLowSerotonin

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 84220 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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