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See a sample rate comparisonCPT 84376 Fee Schedule
Last Verified: September 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.
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 | None 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 84376 |
| Medicaid Fee Schedule | View Medicaid rates for 84376 |
National average reimbursement for CPT 84376 by major payers:
$4.89
$3.91
$6.54
$8.07
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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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Payer Contract Negotiation
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See a sample payer proposalCPT 84376 vs. Other Chemistry Procedures Codes
The CPT 84376 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 84376 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 |
|---|---|---|
| 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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