Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 84285 Fee Schedule
Last Verified: October 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 Detection Test, This Test Evaluates Long-Term Inhalation Of Silica Dust Which Is Present In Rock Mining And Manufacturing. Resulting Inflammation And Scarring Of Lung Tissue Is Called Silicosis.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory 59 - Distinct Procedural Service PN - Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital |
| Complexity Level | Low |
| Medicare Fee Schedule | $25.21 national lab fee schedule rate (2026) · View Medicare rates for 84285 |
| Medicaid Fee Schedule | $23.195 median of the 8 states in the free preview · View Medicaid rates for 84285 |
National average reimbursement for CPT 84285 by major payers:
$21.84
$16.51
$26.51
$36.52
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 84285.
CPT 84285
5 of 25 sample ratesHigher to lower in this preview
El Paso County Hospital District, University Medical Center Of El Paso
El Paso County Hospital District
$82.50Published rateUniversity Healthcare System, L.C., Tulane Lakeside Hospital
$28.90Published rateClhg-Winn, LLC, Winn Parish Medical Center
$22.69Published rateEl Campo Memorial Hospital
$13.81Published rateBrandon Okeefe Rafaeli
U T Physicians
$10.59Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 84207-CPT | Low | Pyridoxine (Vitamin B 6) |
| 84285-CPT | Low | Silica Detection Test, This Test Evaluates Long-Term Inhalation Of Silica Dust Which Is Present In Rock Mining And Manufacturing. Resulting Inflammation And Scarring Of Lung Tissue Is Called Silicosis. |
| 84302-CPT | Low | Sodium Electrolyte Test, Sodium Is An Electrolyte Helping The Body Stay Hydrated. The Blood Test Determines Fluid Retention Or Dehydration. The Urine Test Detects Too Much Or Too Little Sodium. The Tests Help Monitor High Blood Pressure And Kidney Function. |
| 84425-CPT | Low | Vitamin B1 Deficiency Test, This Test Can Measure A Deficiency Of Vitamin B1 (Thiamine). Thiamine Helps Convert Carbohydrates To Energy And Is Good For The Heart Muscles And Nerves. |
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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 84285) and we'll show you how you compare in 15 minutes or less.