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See a sample rate comparisonCPT 84376 Fee Schedule
Medicare rates as of January 2026
CPT 84376 is classified under Pathology and Laboratory Procedures, in the Chemistry Procedures subgroup.
Test Sugar Level In Specimen, The Test Is Used To Evaluate If An Infant Is Not Meeting Growth Benchmarks (Failure To Thrive) As A Result Of Inherited Imbalances In Fructose Sucrose Or Lactose.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $5.50 national lab fee schedule rate (2026) · View Medicare rates for 84376 |
| Medicaid Fee Schedule | $5.43 median of the 8 states in the free preview · View Medicaid rates for 84376 |
National average reimbursement for CPT 84376 by major payers:
$4.89
BCBS / Anthem
$3.91
UnitedHealthcare
$6.54
Aetna
$8.07
Cigna
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CPT 84376
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$60.00Published rateChristopher Raio
St Joseph Hospital
$7.53Published rateEmerus Bhs Sa Thousand Oaks LLC
$5.50Published rateCharleston Radiologists PA
Charleston Radiologists, P.A.
$4.02Published rateChristopher Raio
St Francis Hospital
$2.97Published rate
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See a sample payer proposalCPT 84376 vs. Other Chemistry Procedures Codes
The table lists codes related to 84376. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 84375-CPT | Low | Test For Metabolic Condition, This Test Is Used To Identify Inherited Metabolic Conditions Involving The Production Or Processing Of Sugars Such As Fructose Galactose And Lactose. |
| 84376-CPT | Low | Test Sugar Level In Specimen, The Test Is Used To Evaluate If An Infant Is Not Meeting Growth Benchmarks (Failure To Thrive) As A Result Of Inherited Imbalances In Fructose Sucrose Or Lactose. |
| 84377-CPT | Low | Test Sugar Level In Specimen, The Test Is Used To Evaluate If An Infant Is Not Meeting Growth Benchmarks (Failure To Thrive) As A Result Of Inherited Imbalances In Fructose Sucrose Or Lactose. |
| 84379-CPT | Low | Test Sugar Level In Specimen, The Test Is Used To Evaluate If An Infant Is Not Meeting Growth Benchmarks (Failure To Thrive) As A Result Of Inherited Imbalances In Fructose Sucrose Or Lactose. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84376. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84376 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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