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See a sample rate comparisonCPT 84478 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.
Triglycerides, Blood
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | $5.74 national lab fee schedule rate (2026) · View Medicare rates for 84478 |
| Medicaid Fee Schedule | $5.67 median of the 8 states in the free preview · View Medicaid rates for 84478 |
National average reimbursement for CPT 84478 by major payers:
$4.65
$4.08
$6.99
$8.75
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CPT 84478
5 of 25 sample ratesHigher to lower in this preview
Steven Russo
Premier Family Healthcare PA
$8.39Published rateIrene Cueto
Meadow Health LLC
$3.44Published rateA A Parangi Md PA
$2.60Published rateSasan Parangi
A A Parangi Md PA
$2.60Published rateMiddlesex Medical Group
$2.09Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 84478 vs. Other Chemistry Procedures Codes
The CPT 84478 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 84478 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 |
|---|---|---|
| 84466-CPT | Low | Iron Protein Test, The Test Measures Levels Of Transferrin A Blood Protein Designed To Carry Iron. Because The Protein Is Made In The Liver Transferrin Amounts Change With Liver Disease Or Nutrition Problems. |
| 84478-CPT | Low | Triglycerides, Blood |
| 84520-CPT | Low | Kidney Function Test, This Test Evaluates Either Blood Or Urine For Urea A Byproduct Of Protein Digestion. Blood Tests Evaluate How Well The Kidneys Filter Waste. Urine Tests Can Identify A Protein Deficiency. |
| 84525-CPT | Low | Kidney Function Test, This Test Evaluates Either Blood Or Urine For Urea A Byproduct Of Protein Digestion. Blood Tests Evaluate How Well The Kidneys Filter Waste. Urine Tests Can Identify A Protein Deficiency. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84478. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84478 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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