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CPT 84560 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.

Uric Acid Test, This Test Evaluates Either Blood Or Urine For Uric Acid. The Blood Test Detects How Well The Kidneys Filter Uric Acid. The Urine Test Measures Excess Uric Acid That May Be Forming Crystals As Kidney Stones Or Gout Deposits.
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Chemistry Procedures

Common Place of Service

81 - Independent Laboratory

21 - Inpatient Hospital

Common Modifiers

90 - Reference Laboratory

26 - Professional component

Complexity LevelLow
Medicare Fee Schedule$5.08 national lab fee schedule rate (2026) · View Medicare rates for 84560
Medicaid Fee Schedule$5.015 median of the 8 states in the free preview · View Medicaid rates for 84560

National average reimbursement for CPT 84560 by major payers:

bcbs

$4.35

uhc

$3.45

aetna

$5.69

cigna

$7.79

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CPT 84560
5 of 25 sample ratesHigher to lower in this preview
  1. Restorative Health Rehabilitation Inc

    FLHome Health AgencyNPI 1649599168Tax ID 27-2533824

    $55.00Published rate
  2. Our Lady Of The Lake Assumption Community Hospital, Assumption Community Hospital

    Our Lady Of The Lake Assumption Community Hospital Inc

    LARural Acute Care HospitalNPI 1609860360Tax ID 72-1495500

    $5.07Published rate
  3. Charleston Radiologists PA

    Charleston Radiologists, P.A.

    SCDiagnostic Radiology PhysicianNPI 1811000177Tax ID 57-0634747

    $3.47Published rate
  4. Molly Mcintosh

    Baycare Medical Group Inc

    FLHome Health AgencyNPI 1023438009Tax ID 59-3140335

    $2.73Published rate
  5. Brittany Ptachick

    Hroa 401k Plan

    VAFamily Nurse PractitionerNPI 1053866707Tax ID 54-1958039

    $2.13Published rate

National sample. Rates vary by location, specialty, and contract.

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CPT 84560 vs. Other Chemistry Procedures Codes

The CPT 84560 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 84560 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.

CodeComplexityDescription
84520-CPTLowKidney 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-CPTLowKidney 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.
84545-CPTLowKidney 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.
84560-CPTLowUric Acid Test, This Test Evaluates Either Blood Or Urine For Uric Acid. The Blood Test Detects How Well The Kidneys Filter Uric Acid. The Urine Test Measures Excess Uric Acid That May Be Forming Crystals As Kidney Stones Or Gout Deposits.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84560. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 84560 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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