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See a sample rate comparisonCPT 84704 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 To Measure Hcg, This Test Measures The Beta Subunit Of The Human Chorionic Gonadotropin (Hcg) Protein. This Test Is Offered As Prenatal Screening In Pregnant Women To Identify The Risk Of The Baby Having Down Syndrome Or Certain Other Abnormalities.
| 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 | $15.29 national lab fee schedule rate (2026) · View Medicare rates for 84704 |
| Medicaid Fee Schedule | $15.10 median of the 8 states in the free preview · View Medicaid rates for 84704 |
National average reimbursement for CPT 84704 by major payers:
$16.72
$13.32
$16.56
$46.87
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CPT 84704
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$33.64Published rateChristopher Raio
St Joseph Hospital
$18.65Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$15.29Published rateNicole Schwab
Allergy & Asthma Of Dupage, S.C.
$12.23Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$6.88Published rate
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See a sample payer proposalCPT 84704 vs. Other Chemistry Procedures Codes
The CPT 84704 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 84704 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 |
|---|---|---|
| 84560-CPT | Low | 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. |
| 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. |
| 84703-CPT | Low | Test To Measure Hcg, This Test Measures The Presence Or Absence Of Human Chorionic Gonadotropin (Hcg). This Test Is Generally Used To Determine Pregnancy. Other Rare Uses May Include Testing For Certain Cancers That Arise From The Placenta Or Some Testicular Cancers. |
| 84704-CPT | Low | Test To Measure Hcg, This Test Measures The Beta Subunit Of The Human Chorionic Gonadotropin (Hcg) Protein. This Test Is Offered As Prenatal Screening In Pregnant Women To Identify The Risk Of The Baby Having Down Syndrome Or Certain Other Abnormalities. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84704. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84704 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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