CPT 89280 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 | Reproductive Medicine Procedures Pathology and Laboratory Procedures |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 89280 |
National average reimbursement for CPT 89280 by major payers:
$971.07
$1,101.26
$710.75
$1,099.06
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 89280 | $2096.20 | 1477759611 - JACLYN COLETTA LUCAS | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 89280 | $1241.42 | 1780181982 - RACHEL WEBSTER | 113542367 - (NY) FIRST CHOICE PHYSICIAN / MAIMONIDES FACULTY PRACTICE PLAN / MAIMONIDES MEDICAL CENTER MAIMONIDES PRIMARY CARE FPP | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 89280 | $1241.42 | 1912087495 - GITI BENSINGER | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | Female Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician (207VF0040X) |
United | 89280 | $1791.13 | 1023065158 - LISA KUMP-CHECCHIO | 135562308 - NEW YORK UNIVERSITY | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89280 | $1478.82 | 1477547909 - ROBERT CERVENKA | 10212444 - YORK HOSPITAL | ME | Obstetrics & Gynecology Physician (207V00000X) |
United | 89280 | $1394.84 | 1700278223 - ALBERT PALILEO | 342010563 - (NY) MMC OBGYN FACULTY PRACTICE PLAN / MMC OBGYN FPP / MMC OBGYN HOSPITAL | NY | Gynecologic Oncology Physician (207VX0201X) |
United | 89280 | $2157.26 | 1962499384 - RACHEL MCCONNELL | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89280 | $2157.26 | 1760892301 - IRIS INSOGNA | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89280 | $1500.11 | 1790794345 - ROBERT CRANDALL | 20315693 - CATHOLIC MEDICAL CENTER | NH | Obstetrics & Gynecology Physician (207V00000X) |
United | 89280 | $2075.31 | 1972878148 - WHITNEY BOOKER | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 89280 | $1854.33 | 1336151950 - JEFFREY KLEIN | 851786328 - (NY) REPRODUCTIVE MEDICINE ASSOCIATES OF NEW YORK AT CAREMOUNT PLLC / REPRODUCTIVE MEDICINE ASSOCIATES OF NY LLP | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89280 | $1241.42 | 1144251323 - MICHAEL WENOF | 111635081 - (NY) MAIMONIDES MEDICAL CENTER- | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 89280 | $2135.75 | 1811041288 - SAMUEL WILLIAMS | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89280 | $1241.42 | 1427481761 - AMIR MOR | 113268978 - (NY) MMC REPRODUCTIVE ENDOCRINOLOGY | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 89280 | $1190.00 | 1649350612 - BRENDA HOUMARD | 770622277 - (WA) SEATTLE REPRODUCTIVE MEDICINE | WA | Reproductive Endocrinology Physician (207VE0102X) |
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 89280 vs. Other Pathology and Laboratory Procedures Codes
The CPT 89280 code is part of the Reproductive Medicine 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 89280 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 |
|---|---|---|
| 89253-CPT | Moderate | Fertility Procedure, Laboratory Procedure To Help Induce A Pregnancy Through In-Vitro Fertilization Or Another Infertility Treatment Technique. |
| 89280-CPT | Moderate | In Vitro Fertilization, Ova (Human Eggs) Are Fertilized In A Lab Setting. Individual Sperm Are Injected Into Each Oocyte (Human Egg) Using Micro-Techniques. |
| 89281-CPT | High | In Vitro Fertilization, Ova (Human Eggs) Are Fertilized In A Lab Setting. Individual Sperm Are Injected Into Each Oocyte (Human Egg) Using Micro-Techniques. |
| 89290-CPT | Moderate | Egg Or Embryo Cell Analysis, The Analysis Examines A Single Cell From A Human Egg Or Embryo For Genetic Traits And Disorders. The Testing Is Done When There Is A Family History Or When Assisted Reproduction Is Experiencing Difficulties. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 89280. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 89280 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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