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See a sample rate comparisonCPT 84228 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.
Malaria Medication Monitoring, Quinine Is An Antimalarial Drug That Can Cause Severe Side Effects. Its Use Is Monitored To Ensure The Lowest Possible Therapeutic Dose As Well As To Check For Toxicity.
| Key Fact | Detail |
|---|---|
| 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 Level | Low |
| Medicare Fee Schedule | View Medicare rates for 84228 |
| Medicaid Fee Schedule | View Medicaid rates for 84228 |
National average reimbursement for CPT 84228 by major payers:
$10.48
$8.26
$12.76
$17.74
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CPT 84228
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$25.59Published rateAsya Segalene
Allergy & Asthma Of Dupage, S.C.
$13.65Published rateNavarro Hospital Lp, Navarro Regional Hospital
$11.63Published ratePalo Pinto County Hospital District, Palo Pinto General Hospital
$9.76Published rateVictory Medical Center Landmark, Lp
$4.19Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 84207-CPT | Low | Pyridoxine (Vitamin B 6) |
| 84228-CPT | Low | Malaria Medication Monitoring, Quinine Is An Antimalarial Drug That Can Cause Severe Side Effects. Its Use Is Monitored To Ensure The Lowest Possible Therapeutic Dose As Well As To Check For Toxicity. |
| 84275-CPT | Low | Sialic Acid Enzyme Test, This Test Measures The Amount Of Sialic Acid In The Body. Sialic Acid Is Part Of The Digestion Process That Breaks Down Sugar-Protein Complexes. |
| 84449-CPT | Low | Cortisol Binding Protein Test, Cortisol Binding Protein Is A Measure Of Adrenal Gland Function. It Also Plays A Role In Metabolism Of Fats And Water. The Test Is Used To Evaluate Or Identify A Variety Of Conditions. |
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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