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CPT 84285 Fee Schedule

Last Verified: December 2025

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

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$40.001801164967 - DA PEDIATRIC REHABILITATION270939565 - (FL) DA PEDIATRIC REHABILITATIONFLHome Health Agency (251E00000X)
United
84285$60.001649599168 - RESTORATIVE HEALTH REHABILITATION INC272533824 - (FL) RESTORATIVE HEALTH REHABILITATION INCFLHome Health Agency (251E00000X)
United
84285$13.811003192311 - EL CAMPO MEMORIAL HOSPITAL452750258 - (TX) EL CAMPO MEMORIAL HOSPITALTXGeneral Acute Care Hospital (282N00000X)
United
84285$25.201457994188 - VHS HARLINGEN HOSPITAL COMPANY, LLC, VALLEY BAPTIST MICRO-HOSPITAL WESLACO452662980TXGeneral Acute Care Hospital (282N00000X)
United
84285$82.501275235426 - EMERUS BHS SA THOUSAND OAKS LLC452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
84285$28.901497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL621596506LAGeneral Acute Care Hospital (282N00000X)
United
84285$10.591992720791 - OMEGA HOSPITAL LLC470901008 - (LA) OMEGA HOSPITAL, LLCLAGeneral Acute Care Hospital (282N00000X)
United
84285$32.261255478004 - CHRISTOPHER RAIO113438973 - ST JOSEPH HOSPITALNYEmergency Medicine Physician (207P00000X)
United
84285$22.691467496802 - ST FRANCIS HOSPITAL, INC., ST. FRANCIS EASTSIDE582504530 - (SC) ST FRANCIS HOSPITAL INCSCGeneral Acute Care Hospital (282N00000X)
United
84285$13.611255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
84285$19.271821098286 - TOURO INFIRMARY720423659 - (LA) TOURO INFIRMARYLAGeneral Acute Care Hospital (282N00000X)
United
84285$10.971831220904 - METHODIST HOSPITAL PLAINVIEW TEXAS, COVENANT HOSPITAL PLAINVIEW752426010 - (TX) METHODIST HOSPITAL PLAINVIEW TEXASTXGeneral Acute Care Hospital (282N00000X)
United
84285$25.201902857766 - COLUMBIA MEDICAL CENTER OF LAS COLINAS INC, MEDICAL CITY LAS COLINAS621650582 - (TX) COLUMBIA MEDICAL CENTER OF LAS COLINAS INCTXGeneral Acute Care Hospital (282N00000X)
United
84285$25.201609860360 - OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL, ASSUMPTION COMMUNITY HOSPITAL721495500 - (LA) OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INCLARural Acute Care Hospital (282NR1301X)
United
84285$29.611396394961 - CLHG-ACADIAN, LLC, ACADIAN MEDICAL CENTER825359949LAGeneral 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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