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See a sample rate comparisonCPT 84234 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.
Cancer Treatment Assessment, Testing The Receptive Ability Of The Hormone Progesterone Is Used To Assess The Likelihood Of Cancer Treatment Effectiveness. Treatment For Several Types Of Cancer May Be Evaluated With This Test.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 95 - Telemedicine - audio and video 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 84234 |
| Medicaid Fee Schedule | View Medicaid rates for 84234 |
National average reimbursement for CPT 84234 by major payers:
$55.85
$45.88
$66.76
$93.56
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CPT 84234
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
Good Samaritan Hosptial Medical Center
$88.91Published rateEmerus Bhs Sa Thousand Oaks LLC, Baptist Neighborhood Hospital Shavano Park
Emerus Bhs Sa Thousand Oaks LLC
$64.87Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Grove
Prisma Health - Upstate
$58.38Published rateMolly Mcintosh
Baycare Medical Group Inc
$37.38Published rateBrittany Ptachick
Hroa 401k Plan
$27.25Published rate
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See a sample payer proposalCPT 84234 vs. Other Chemistry Procedures Codes
The CPT 84234 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 84234 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 |
|---|---|---|
| 84233-CPT | Low | Breast Cancer Therapy Test, The Test Checks How A Sample Of Tissue (Biopsy) Responds To Chemotherapy Or Hormone Therapy That Has Been Proposed To Treat Breast Cancer. |
| 84234-CPT | Low | Cancer Treatment Assessment, Testing The Receptive Ability Of The Hormone Progesterone Is Used To Assess The Likelihood Of Cancer Treatment Effectiveness. Treatment For Several Types Of Cancer May Be Evaluated With This Test. |
| 84235-CPT | Low | Hormone Receptor Test, This Test Evaluates How Well A Particular Hormone Sends And Receives Information So That Processes Within The Body Perform Optimally. |
| 84238-CPT | Low | Receptor Assay;Non-Endocrine-Eg,Acetylch |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84234. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84234 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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