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See a sample rate comparisonCPT 84235 Fee Schedule
Medicare rates as of January 2026
CPT 84235 is classified under Pathology and Laboratory Procedures, in the Chemistry Procedures subgroup.
Hormone Receptor Test, This Test Evaluates How Well A Particular Hormone Sends And Receives Information So That Processes Within The Body Perform Optimally.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $71.23 national lab fee schedule rate (2026) · View Medicare rates for 84235 |
| Medicaid Fee Schedule | $70.34 median of the 8 states in the free preview · View Medicaid rates for 84235 |
National average reimbursement for CPT 84235 by major payers:
$55.78
BCBS / Anthem
$42.74
UnitedHealthcare
$69.27
Aetna
$99.68
Cigna
Compare published rates across providers.
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CPT 84235
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$156.71Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$71.23Published rateGreenville Health System, Ghs Patewood Memorial Hospital
Prisma Health - Upstate
$64.11Published rateChristopher Raio
St Francis Hospital
$38.46Published rateMethodist Hospital Plainview Texas, Covenant Hospital Plainview
Methodist Hospital Plainview Texas
$29.92Published rate
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See a sample payer proposalCPT 84235 vs. Other Chemistry Procedures Codes
The table lists codes related to 84235. Select one to see its fee schedule.
| 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. |
| 84402-CPT | Low | Testosterone Hormone Test, Testosterone Helps Balance Male-Female Secondary Sex Characteristics Like Body Hair. Results Help Evaluate Pituitary Gland And Sex Gland Conditions. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84235. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84235 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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