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CPT 89240 Fee Schedule

Last Verified: November 2025

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Unlisted Miscellaneous Pathology Test
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Other Pathology and Laboratory Procedures

Common Place of Service

99 - Other POS

50 - Federally Qualified Health Center

Common Modifiers

None

26 - Professional component

90 - Reference Laboratory

Complexity LevelHigh

National average reimbursement for CPT 89240 by major payers:

bcbs

$1,123.22

uhc

$13.37

aetna

$23.94

cigna

$105.22

Preview provider-level rates for...
For billing codeCPT 89240
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 89240

United
89240$49.471003925959 - HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA., HOOD MEMORIAL HOSPITAL720694946 - (LA) HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LALACritical Access Hospital (282NC0060X)
United
89240$60.901316931835 - WILBARGER COUNTY HOSPITAL DISTRICT, WILBARGER GENERAL HOSPITAL756047638 - (TX) WILBARGER GENERAL HOSPITAL EMPLOYEE BENEFIT PLANTXGeneral Acute Care Hospital (282N00000X)
United
89240$119.881578568481 - SLIDELL MEMORIAL HOSPITAL, ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2726014895 - (LA) SLIDELL MEMORIAL HOSPITALLAGeneral Acute Care Hospital (282N00000X)
United
89240$49.471003925959 - HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA., HOOD MEMORIAL HOSPITAL720694946 - (LA) HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LALACritical Access Hospital (282NC0060X)
United
89240$2.131700854288 - LAMB HEALTHCARE CENTER752388515 - (TX) LAMB HEALTHCARE CENTERTXGeneral Acute Care Hospital (282N00000X)
United
89240$42.971831183748 - HOMER MEMORIAL HOSPITAL, CLAIBORNE MEMORIAL MEDICAL CENTER720396868 - (LA) HOMER MEMORIAL HOSPITALLAGeneral Acute Care Hospital (282N00000X)
United
89240$49.751659323772 - COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP, MEDICAL CITY FORT WORTH621682202 - (TX) COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LPTXGeneral Acute Care Hospital (282N00000X)
United
89240$49.751679528889 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER742781812TXGeneral Acute Care Hospital (282N00000X)
United
89240$49.751861994808 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE NORTHEAST CAMPUS813935393 - (TX) HCN EP HORIZON CITY LLCTXGeneral Acute Care Hospital (282N00000X)
United
89240$45.681942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY741282696 - ST JOSEPH REGIONAL HEALTH CENTERTXGeneral Acute Care Hospital (282N00000X)
United
89240$45.881851632616 - LANCASTER REGIONAL HOSPITAL, LP, CRESCENT MEDICAL CENTER LANCASTER273815440 - (TX) LANCASTER REGIONAL HOSPITAL, LPTXGeneral Acute Care Hospital (282N00000X)
United
89240$49.751679528889 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, ST. DAVID'S SOUTH AUSTIN MEDICAL CENTER742781812TXGeneral Acute Care Hospital (282N00000X)
United
89240$49.751689628984 - COLUMBIA HOSPITAL AT MEDICAL CITY DALLAS SUBSIDIARY LP, MEDICAL CITY DALLAS621682198TXGeneral Acute Care Hospital (282N00000X)
United
89240$49.751215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
89240$2.131447259627 - TYLER COUNTY HOSPITAL DISTRICT746067306TXGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 89240 vs. Other Other Pathology and Laboratory Procedures Codes

The CPT 89240 code is part of the Pathology and Laboratory Procedures services used for Other 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 89240 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.

CodeComplexityDescription
89050-CPTLowCell Count,Misc.Body Fluids,Not Bld
89051-CPTLowCell Cnt,Misc.Bdy Fluids;W/Diff.Cnt
89055-CPTLowLeukocyte Count, Fecal
89240-CPTHighUnlisted Miscellaneous Pathology Test

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 89240. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 89240 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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