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See a sample rate comparisonCPT 84220 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.
Blood Test Pyruvate, This Blood Test Measures Pyruvate Which Is Formed As Digestion Breaks Down Carbohydrates And Proteins. When There Is A Deficiency The Cells Do Not Get Enough Energy.
| Key Fact | Detail |
|---|---|
| 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 Level | Low |
| Medicare Fee Schedule | View Medicare rates for 84220 |
| Medicaid Fee Schedule | View Medicaid rates for 84220 |
National average reimbursement for CPT 84220 by major payers:
$8.35
$6.65
$11.79
$13.85
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CPT 84220
5 of 25 sample ratesHigher to lower in this preview
Carthage Hospital, LLC
$22.50Published rateChristopher Raio
St Joseph Hospital
$11.21Published rateSt. David'S Healthcare Partnership, L.P., LLP, St. David'S South Austin Medical Center
$9.43Published rateNevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
$5.54Published rateEctor County Hospital District, Medical Center Hospital
$3.96Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 84206-CPT | Low | Digestive Enzyme Test, The Test Measures Proinsulin Made By The Pancreas To Help Digest Sugars. It Is Involved In The Conversion Of Glucose. |
| 84210-CPT | Low | Blood Test Pyruvate, This Blood Test Measures Pyruvate Which Is Formed As Digestion Breaks Down Carbohydrates And Proteins. When There Is A Deficiency The Cells Do Not Get Enough Energy. |
| 84220-CPT | Low | Blood Test Pyruvate, This Blood Test Measures Pyruvate Which Is Formed As Digestion Breaks Down Carbohydrates And Proteins. When There Is A Deficiency The Cells Do Not Get Enough Energy. |
| 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. |
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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