Data Platform
Sign InTry for Free

CPT 84305 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.

Somatomedin
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

26 - Professional component

Complexity LevelLow

National average reimbursement for CPT 84305 by major payers:

bcbs

$17.96

uhc

$18.86

aetna

$24.75

cigna

$31.97

Preview provider-level rates for...
For billing codeCPT 84305
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 84305

United
84305$12.761548260482 - MAIN LINE PATHOLOGY ASSOCIATES, PC232786651 - (PA) MAIN LINE PATHOLOGY ASSOCIATES, P.CPAClinical Pathology/Laboratory Medicine Physician (207ZP0105X)
United
84305$21.261871911016 - NORTH TEXAS, MEDICAL CITY ALLIANCE464027347 - (TX) NORTH TEXASTXGeneral Acute Care Hospital (282N00000X)
United
84305$21.261447230388 - OPELOUSAS GENERAL HOSPITAL AUTHORITY720708111LAGeneral Acute Care Hospital (282N00000X)
United
84305$21.261699726406 - COLUMBIA MEDICAL CENTER OF PLANO SUBSIDIARY LP, MEDICAL CITY PLANO621682203TXGeneral Acute Care Hospital (282N00000X)
United
84305$23.391366428401 - AARON ASKEW931224010 - PRAXIS HEALTH, P.C.OROrthopaedic Trauma Physician (207XX0801X)
United
84305$23.391366428401 - AARON ASKEW931224010 - PRAXIS HEALTH, P.C.OROrthopaedic Trauma Physician (207XX0801X)
United
84305$21.261487271375 - METHODIST HOSPITALS OF DALLAS, METHODIST MIDLOTHIAN MEDICAL CENTER750800661 - METHODIST HOSPITALS OF DALLASTXGeneral Acute Care Hospital (282N00000X)
United
84305$12.471235177320 - BIENVILLE MEDICAL CENTER, INC.743227578LACritical Access Hospital (282NC0060X)
United
84305$12.641013212448 - GUSTAVO DELGADO746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
84305$21.261609860360 - OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL, ASSUMPTION COMMUNITY HOSPITAL721495500 - (LA) OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INCLACritical Access Hospital (282NC0060X)
United
84305$21.261932204427 - NMC OPERATING COMPANY LLC, THE SPINE HOSPITAL OF LOUISIANA270059959 - (LA) NMC OPERATING COMPANY, LLCLAGeneral Acute Care Hospital (282N00000X)
United
84305$17.811962024026 - CLHG-RUSTON LLC844422249LAGeneral Acute Care Hospital (282N00000X)
United
84305$21.261821465576 - LAKE SURGICAL HOSPITAL SLIDELL, LLC, SOUTHERN SURGICAL HOSPITAL474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITALLAGeneral Acute Care Hospital (282N00000X)
United
84305$21.261932284411 - FOUNDATION BARIATRIC HOSPITAL OF SAN ANTONIO, LLC, FOUNDATION SURGICAL HOSPITAL OF SAN ANTONIO203793927 - (TX) FOUNDATION BARIATRIC HOSPITAL OF SAN ANTONIO, LLCTXGeneral Acute Care Hospital (282N00000X)
United
84305$12.471134126659 - CALDWELL MEMORIAL HOSPITAL INC720878037 - (LA) CALDWELL MEMORIAL HOSPITAL, INC.LAGeneral 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

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

CPT 84305 vs. Other Chemistry Procedures Codes

The CPT 84305 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 84305 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
84238-CPTLowReceptor Assay;Non-Endocrine-Eg,Acetylch
84260-CPTLowSerotonin
84270-CPTLowSex Hormone Binding Globulin (Shbg)
84305-CPTLowSomatomedin

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84305. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 84305 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 84305) and we'll show you how you compare in 15 minutes or less.