CPT 84620 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 | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory |
| Common Modifiers | None 90 - Reference Laboratory 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 84620 |
| Medicaid Fee Schedule | View Medicaid rates for 84620 |
National average reimbursement for CPT 84620 by major payers:
$11.13
$8.74
$13.85
$19.05
CPT 84620 vs. Other Chemistry Procedures Codes
The CPT 84620 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 84620 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 |
|---|---|---|
| 84583-CPT | Low | Urobilinogen,Urine;Semiquantitative |
| 84585-CPT | Low | Stress Hormone Urine Test, The Test Is Done To Diagnose Adrenal Gland And Nerve Tumors By Measuring The Amounts Of Adrenalin Byproducts In Urine. |
| 84600-CPT | Low | Volatiles (Eg Acetic Anhydrid, Volatiles (Eg Acetic Anhydride Carbon Tetrachloridedichloroethane Dichloromethane Diethyletherisopropyl Alcohol Methanol) |
| 84620-CPT | Low | Xylose Tolerance Test, Xylose Is A Simple Sugar That Is Produced As Carbohydrates Are Digested. The Test Evaluates How Well The Intestines Absorb Nutrients. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84620. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84620 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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