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See a sample rate comparisonCPT 84490 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $9.93 national lab fee schedule rate (2026) · View Medicare rates for 84490 |
| Medicaid Fee Schedule | $9.805 median of the 8 states in the free preview · View Medicaid rates for 84490 |
National average reimbursement for CPT 84490 by major payers:
$8.12
$6.20
$10.54
$13.97
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CPT 84490
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$40.00Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$10.63Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$7.26Published rateNicole Schwab
Allergy & Asthma Of Dupage, S.C.
$5.00Published rateSacred Heart Health System Inc, Sacred Heart Home Care
Sacred Heart Health System Inc
$4.13Published rate
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See a sample payer proposalCPT 84490 vs. Other Chemistry Procedures Codes
The CPT 84490 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 84490 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. |
| 84540-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 84490. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84490 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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