Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 89255 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.
Fertility Procedure, Laboratory Procedure To Help Induce A Pregnancy Through In-Vitro Fertilization Or Another Infertility Treatment Technique.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Reproductive Medicine Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | 59 - Distinct Procedural Service V1 |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 89255 |
National average reimbursement for CPT 89255 by major payers:
$258.45
$212.67
$305.75
$888.10
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 89255.
CPT 89255
5 of 25 sample ratesHigher to lower in this preview
Lauren Verrilli
University Of Utah / Utah Center For Reproductive Medicine
$968.63Published rateYelena Dondik
New York University
$365.38Published rateEileen Demarco
Columbia University In The City Of New York
$307.60Published rateMary D'Alton
Columbia University In The City Of New York
$298.91Published rateAshish Chaudhari
Cheshire Medical Center
$152.61Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 89255 vs. Other Reproductive Medicine Procedures Codes
The CPT 89255 code is part of the Pathology and Laboratory Procedures services used for Reproductive Medicine 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 89255 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 |
|---|---|---|
| 89255-CPT | Moderate | Fertility Procedure, Laboratory Procedure To Help Induce A Pregnancy Through In-Vitro Fertilization Or Another Infertility Treatment Technique. |
| 89257-CPT | Low | Sperm Collection From Testicle, This Procedure Collects Fluid Or Tissue Directly From A Testicle To Find Out If Sperm Are Present. Fluid Is Taken To Help Diagnose A Blockage. Tissue Is Sampled When Other Methods Would Damage The Testicle. |
| 89258-CPT | Moderate | Cryopreservation; Embryo |
| 89268-CPT | Moderate | Insemination Of Oocytes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 89255. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 89255 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 89255) and we'll show you how you compare in 15 minutes or less.