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CPT 84228 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.

Quinine
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Chemistry Procedures

Common Place of Service

81 - Independent Laboratory

Common Modifiers

None

GW - Condition not related to the patient's terminal condition

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 84228

National average reimbursement for CPT 84228 by major payers:

bcbs

$10.48

uhc

$8.26

aetna

$12.76

cigna

$17.74

Preview provider-level rates for...
For billing codeCPT 84228
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 84228

United
84228$10.471629432869 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH OP SURGERY SPARTANBURG811723202 - PRISMA HEALTH - UPSTATESCGeneral Acute Care Hospital (282N00000X)
United
84228$15.351255478004 - CHRISTOPHER RAIO113438973 - ST JOSEPH HOSPITALNYEmergency Medicine Physician (207P00000X)
United
84228$10.471720747496 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH TRANSPLANT CENTER811723202 - PRISMA HEALTH - UPSTATESCGeneral Acute Care Hospital (282N00000X)
United
84228$11.631073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
84228$25.591073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
84228$17.451003166612 - MATTHEW LILLEY680637976 - BEND MEMORIAL CLINIC, PCOROrthopaedic Surgery Physician (207X00000X)
United
84228$11.631073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
84228$5.421770573586 - MCALLEN HOSPITALS L P, SOUTH TEXAS HEALTH SYSTEM233069260TXGeneral Acute Care Hospital (282N00000X)
United
84228$22.181255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
84228$11.631467129700 - VHS SAN ANTONIO PARTNERS, LLC, NORTHEAST BAPTIST HOSPITAL760714523TXGeneral Acute Care Hospital (282N00000X)
United
84228$4.191568801116 - VICTORY MEDICAL CENTER LANDMARK, LP474612520TXGeneral Acute Care Hospital (282N00000X)
United
84228$8.501811000177 - CHARLESTON RADIOLOGISTS PA570634747 - CHARLESTON RADIOLOGISTS, P.A.SCSingle Specialty Group (193400000X)
United
84228$11.631982800397 - PELHAM MEDICAL CENTER141996067SCGeneral Acute Care Hospital (282N00000X)
United
84228$10.471437605532 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CENTER FOR PEDIATRIC MED811723202 - PRISMA HEALTH - UPSTATESCGeneral Acute Care Hospital (282N00000X)
United
84228$6.981497944565 - MICHAEL SHULER581076549 - ATHENS ORTHOPEDIC CLINIC, PAGAOrthopaedic Hand Surgery Physician (207XS0106X)
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 84228 vs. Other Chemistry Procedures Codes

The CPT 84228 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 84228 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
84207-CPTLowPyridoxine (Vitamin B 6)
84228-CPTLowQuinine
84270-CPTLowSex Hormone Binding Globulin (Shbg)
84275-CPTLowSialic Acid

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84228. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 84228 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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