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See a sample rate comparisonHealthcare 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 | Pathology and Laboratory Procedures Reproductive Medicine Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | 59 - Distinct Procedural Service TG |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 89291 |
National average reimbursement for CPT 89291 by major payers:

$950.44

$1,010.32

$1,027.47

$1,457.39
Choose a payer to see a sample of rates for CPT 89291.
Michelle Russell
Mary Hitchcock Memorial Hospital
Olanrewaju Dawodu
Columbia University In The City Of New York
Stephanie Purisch
Columbia University In The City Of New York
Annie Fu
Columbia University In The City Of New York
Utah Center For Reproductive Medicine
University Of Utah / Utah Center For Reproductive Medicine
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Rate Benchmarking
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See a sample payer proposalCPT 89291 vs. Other Reproductive Medicine Procedures Codes
The CPT 89291 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 89291 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 |
|---|---|---|
| 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. |
| 89291-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 89291. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 89291 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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