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See a sample rate comparisonCPT 84597 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.
Vitamin K
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $13.72 national lab fee schedule rate (2026) · View Medicare rates for 84597 |
| Medicaid Fee Schedule | $13.55 median of the 8 states in the free preview · View Medicaid rates for 84597 |
National average reimbursement for CPT 84597 by major payers:
$11.89
$9.52
$16.71
$20.19
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CPT 84597
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$60.00Published rateAaron Askew
Praxis Health, P.C.
$15.09Published ratePrisma Health-Upstate, Prisma Health Ctr For Ped & Int Med-West
Prisma Health - Upstate
$12.35Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$8.23Published rateBrittany Ptachick
Hroa 401k Plan
$5.76Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 84597 vs. Other Chemistry Procedures Codes
The CPT 84597 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 84597 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 |
|---|---|---|
| 84588-CPT | Low | Antidiuretic Hormone Test, The Antidiuretic Hormone (Adh) Test Evaluates The Ability Of The Kidneys To Help Regulate The Volume Of Water In The Body. |
| 84590-CPT | Low | Vitamin A (Retinol) Test, This Blood Test Measures The Amount Of Vitamin A Present. The Purpose Is To Verify A Vitamin A Deficiency Or Toxicity (Excess). |
| 84591-CPT | Low | Vitamin Testing, This Is Either A Blood Or Urine Test That Analyzes The Sample For A Specific Vitamin. These Tests Are Done To Assess Deficiencies Primarily. They May Also Identify Excess Amounts Being Stored Or Excreted. |
| 84597-CPT | Low | Vitamin K |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84597. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84597 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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