CPT 89230 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 | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 89230 |
National average reimbursement for CPT 89230 by major payers:
$3.77
$2.64
$4.82
$4.38
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 89230 | $2.86 | 1407996564 - AUSENCIO NUNEZ | 363950044 - PROGRESSIVE MEDICAL CENTER, S.C. | IL | Internal Medicine Physician (207R00000X) |
United | 89230 | $1.89 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 89230 | $4.16 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 89230 | $4.62 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 89230 | $6.42 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 89230 | $1.89 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 89230 | $4.62 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 89230 | $1.51 | 1497944565 - MICHAEL SHULER | 581076549 - ATHENS ORTHOPEDIC CLINIC, PA | GA | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 89230 | $1.23 | 1144370990 - ROLANDO HENRIQUEZ | 363950044 - PROGRESSIVE MEDICAL CENTER, S.C. | IL | Internal Medicine Physician (207R00000X) |
United | 89230 | $55.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 89230 | $1.30 | 1053866707 - BRITTANY PTACHICK | 541958039 - HROA 401K PLAN | VA | Family Nurse Practitioner (363LF0000X) |
United | 89230 | $1.89 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 89230 | $6.42 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 89230 | $4.62 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 89230 | $55.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
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 89230 vs. Other Pathology and Laboratory Procedures Codes
The CPT 89230 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 89230 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. |
| 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. |
| 89160-CPT | Low | Stool Meat Fiber Analysis, This Is A Nutrition And Digestion Test That Analyzes A Stool Sample For Meat Waste Product. |
| 89230-CPT | Low | Sweat Collection Test, The Test Aids In Diagnosis Of Cystic Fibrosis (Cf). Chloride Is Introduced Into The Skin By Low-Level Electric Charge. Sweat Is Collected By Absorbent Pads Taped To The Skin. People With Cf Will Have High Amounts Of Salt In Their Sweat. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 89230. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 89230 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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