CPT 84485 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | Chemistry Procedures Pathology and Laboratory Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | None 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 84485 |
National average reimbursement for CPT 84485 by major payers:
$6.51
$5.60
$8.16
$10.58
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 84485 | $7.19 | 1457382483 - AMISUB OF SOUTH CAROLINA, INC., PIEDMONT MEDICAL CENTER | 953561198 - (SC) AMISUB OF SOUTH CAROLINA INC | SC | General Acute Care Hospital (282N00000X) |
United | 84485 | $8.55 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 84485 | $7.19 | 1144203662 - TOPS SPECIALTY HOSPITAL, LTD., TOPS SURGICAL SPECIALTY HOSPITAL | 760246499 - (TX) TOPS SPECIALTY HOSPITAL LTD | TX | General Acute Care Hospital (282N00000X) |
United | 84485 | $7.20 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 84485 | $22.50 | 1003344334 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE HORIZON CITY CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 84485 | $4.40 | 1235177320 - BIENVILLE MEDICAL CENTER, INC. | 743227578 | LA | Critical Access Hospital (282NC0060X) |
United | 84485 | $7.19 | 1407191984 - BSA HOSPITAL LLC | 300754305 | TX | General Acute Care Hospital (282N00000X) |
United | 84485 | $6.48 | 1467496802 - ST FRANCIS HOSPITAL, INC., ST. FRANCIS EASTSIDE | 582504530 - (SC) ST FRANCIS HOSPITAL INC | SC | General Acute Care Hospital (282N00000X) |
United | 84485 | $9.50 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 84485 | $7.19 | 1770573586 - MCALLEN HOSPITALS L P, SOUTH TEXAS HEALTH SYSTEM | 233069260 | TX | General Acute Care Hospital (282N00000X) |
United | 84485 | $7.19 | 1700801909 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 84485 | $3.60 | 1730385618 - CABRINI SUTHERLAND | 561026666 - SURGICAL SPECIALISTS OF CHARLOTTE, PA | NC | Surgical Critical Care Physician (2086S0102X) |
United | 84485 | $7.19 | 1144203662 - TOPS SPECIALTY HOSPITAL, LTD., TOPS SURGICAL SPECIALTY HOSPITAL | 760246499 - (TX) TOPS SPECIALTY HOSPITAL LTD | TX | General Acute Care Hospital (282N00000X) |
United | 84485 | $6.48 | 1477882033 - SAVOY MEDICAL MANAGEMENT GROUP, INC., SAVOY MEDICAL CENTER HOSPITAL BASED PHYSICIANS | 800202027 - (LA) SAVOY MEDICAL MANAGEMENT GROUP INC | LA | General Acute Care Hospital (282N00000X) |
United | 84485 | $3.89 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 84485 vs. Other Pathology and Laboratory Procedures Codes
The CPT 84485 code is part of the Chemistry Procedures services used for Pathology and Laboratory 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 84485 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 |
|---|---|---|
| 84485-CPT | Low | Test For Trypsin Secretion, The Test Looks For Trypsin In A Sample Of Fluid From The Large Intestine. Trypsin Is An Enzyme Secreted By The Pancreas That Helps Digest Proteins. The Test Evaluates Suspected Problems With The Pancreas Or Digestion. |
| 84488-CPT | Low | Test Of Pancreas Function, This Test Evaluates The Pancreas Function Related To Digestion. A Fecal Sample Is Tested For Trypsin To Confirm A Problem With Secretion Of Digestive Enzymes Or Poor Absorption Of Nutrients. |
| 84490-CPT | Low | Test Of Pancreas Function, This Test Evaluates The Pancreas Function Related To Digestion. A Fecal Sample Is Tested For Trypsin To Confirm A Problem With Secretion Of Digestive Enzymes Or Poor Absorption Of Nutrients. |
| 84702-CPT | Low | Test To Measure Hcg, This Test Measures Hcg (Human Chorionic Gonadotropin) In Blood Or Urine A Protein That Is Elevated In Conditions Related To Conception Pregnancy And Some Cancers In Both Women And Men. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84485. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84485 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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