CPT 89051 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 | Other Pathology and Laboratory Procedures Pathology and Laboratory Procedures |
| Common Place of Service | 21 - Inpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | None 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 89051 |
National average reimbursement for CPT 89051 by major payers:
$5.61
$3.92
$6.91
$8.64
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 89051 | $1.96 | 1083600803 - FRED GRYNBERG | 412117806 - (FL) PULMONARY PHYSICIANS OF SOUTH FLORIDA LLC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 89051 | $8.78 | 1598859852 - JUNAID MALIK | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 89051 | $3.23 | 1578537759 - GEORGE SCHMIEDER | 203091866 - (FL) PARK AVENUE DERMATOLOGY PA | FL | Dermatology Physician (207N00000X) |
United | 89051 | $6.40 | 1184014094 - JOSEPH MARCOTTE | 43306782 - (MA) SIGNATURE HEALTHCARE MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
United | 89051 | $2.34 | 1881851269 - ANGSTEN CENTER FOR PULMONARY & SLEEP | 223867008 - (FL) ANGSTEN CENTER FOR PULMONARY & SLEEP DISORDERS, PA | FL | Pulmonary Disease Physician (207RP1001X) |
United | 89051 | $1.96 | 1164762779 - SHEYLA PAREDES ALLER | 596014973 - (FL) SOUTH BROWARD HOSPITAL DISTRICT | FL | Pulmonary Disease Physician (207RP1001X) |
United | 89051 | $3.38 | 1992045272 - BLUE OCEAN DERMATOLOGY LLC | 371711187 - (FL) BLUE OCEAN DERMATOLOGY LLC | FL | Dermatology Physician (207N00000X) |
United | 89051 | $1.96 | 1306378989 - MARIA ROJAS | 201759480 - (FL) SOUTH FLORIDA SURGICAL SPECIALISTS LLC | FL | Surgery Physician (208600000X) |
United | 89051 | $2.34 | 1457479271 - DERMATOLOGY ASSOCIATES OF NORTHWEST FLORIDA PA, AMY P. WATSON, M.D. | 542149912 - (FL) DERMATOLOGY ASSOCIATES OF NORTHWEST FLORIDA, P.A. | FL | Dermatology Physician (207N00000X) |
United | 89051 | $2.34 | 1932490778 - LINA CARDONA | 593330433 - MID-FLORIDA DERMATOLOGY ASSOCIATES, PA | FL | Dermatology Physician (207N00000X) |
United | 89051 | $1.96 | 1952421208 - MOIZ MUSTAFA | 596014973 - (FL) SOUTH BROWARD HOSPITAL DISTRICT | FL | Surgery Physician (208600000X) |
United | 89051 | $3.23 | 1013905280 - RONALD SMITH | 592582062 | FL | Dermatology Physician (207N00000X) |
United | 89051 | $4.50 | 1336465061 - SURESH KUMAR MANICKAVEL | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Pulmonary Disease Physician (207RP1001X) |
United | 89051 | $2.56 | 1578568515 - THOMAS MAHAN | 593366100 - NORTH FLORIDA SURGEONS, P.A. | FL | Surgery Physician (208600000X) |
United | 89051 | $3.27 | 1043275647 - ADAM GRIGGS | 592545833 - (FL) PULMONARY DISEASE SPECIALISTS, P.A. | FL | Pulmonary Disease Physician (207RP1001X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 89051 vs. Other Pathology and Laboratory Procedures Codes
The CPT 89051 code is part of the Other Pathology and Laboratory Procedures services used for Pathology and Laboratory 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 89051 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 |
|---|---|---|
| 89050-CPT | Low | Analysis Of Body Fluid, This Analysis Usually Looks At Body Fluid From The Spine Or A Joint. Numbers Of Each Type Of Cell That Is Present Are Counted Often To Check For An Infection In The Area Near The Sample. |
| 89051-CPT | Low | Analysis Of Body Fluid, This Analysis Usually Looks At Body Fluid From The Spine Or A Joint. Numbers Of Each Type Of Cell That Is Present Are Counted Often To Check For An Infection In The Area Near The Sample. |
| 89055-CPT | Low | Stool White Blood Cell Count, The Test Identifies White Blood Cells (Wbcs) In A Stool Sample. Presence Absence And Quantity Of Wbcs All Give Clues About What Is Causing Diarrhea. |
| 89060-CPT | Low | Identify Crystals In Specimen, This Analysis Method Identifies Crystals In A Fluid Sample. The Sample Can Be Blood Urine Spinal Fluid Or Fluid Taken From A Site Such As A Swollen Joint. This Testing Method Identifies Conditions Such As Gout And Pseudogout. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 89051. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 89051 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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