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CPT 84285 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.

Silica, Blood, Urineor Tissue
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Chemistry Procedures

Common Place of Service

81 - Independent Laboratory

11 - Office

Common Modifiers

None

90 - Reference Laboratory

59 - Distinct Procedural Service

PN - Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 84285

National average reimbursement for CPT 84285 by major payers:

bcbs

$21.84

uhc

$16.51

aetna

$26.51

cigna

$37.47

Preview provider-level rates for...
For billing codeCPT 84285
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 84285

United
84285$15.131255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
84285$43.591407990088 - PMC HOSPITAL, LLC, ST. LUKE'S PATIENTS MEDICAL CENTER273280598 - (TX) PMC HOSPITAL, LLCTXGeneral Acute Care Hospital (282N00000X)
United
84285$13.811003192311 - EL CAMPO MEMORIAL HOSPITAL452750258 - (TX) EL CAMPO MEMORIAL HOSPITALTXGeneral Acute Care Hospital (282N00000X)
United
84285$25.201588631311 - SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC, SURGICAL SPECIALTY CENTER OF BATON ROUGE263120962 - (LA) SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLCLAGeneral Acute Care Hospital (282N00000X)
United
84285$15.131255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
84285$10.591366442600 - MICHAEL JACOBSON541958039 - HROA 401K PLANVAOtolaryngology Physician (207Y00000X)
United
84285$12.211255728119 - CHANA VAN HOUTEN464454536 - (TX) NADIR MIR ALI MD PLLCTXGeneral Acute Care Hospital (282N00000X)
United
84285$25.201851343909 - VICTORIA OF TEXAS LP, DETAR HEALTHCARE SYSTEM621754940TXGeneral Acute Care Hospital (282N00000X)
United
84285$25.201962472431 - COASTAL CAROLINA MEDICAL CENTER, INC., COASTAL CAROLINA HOSPITAL934580630SCGeneral Acute Care Hospital (282N00000X)
United
84285$82.501316936990 - EL PASO COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER OF EL PASO746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
84285$22.691467496802 - ST FRANCIS HOSPITAL, INC., ST. FRANCIS EASTSIDE582504530 - (SC) ST FRANCIS HOSPITAL INCSCGeneral Acute Care Hospital (282N00000X)
United
84285$13.811508859612 - GONZALES HEALTHCARE SYSTEMS, MEMORIAL HOSPITAL741625013TXGeneral Acute Care Hospital (282N00000X)
United
84285$28.901497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL621596506LAGeneral Acute Care Hospital (282N00000X)
United
84285$10.591427410240 - BRANDON OKEEFE RAFAELI760459500 - U T PHYSICIANSTXGeneral Acute Care Hospital (282N00000X)
United
84285$82.501457994188 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MICRO-HOSPITAL WESLACO452662980TXGeneral Acute Care Hospital (282N00000X)
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 84285 vs. Other Chemistry Procedures Codes

The CPT 84285 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 84285 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)
84220-CPTLowPyruvate Kinase
84285-CPTLowSilica, Blood, Urineor Tissue
84302-CPTLowSodium; Other Source

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 84285 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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