CPT 89291 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 | • Pathology and Laboratory Procedures • Reproductive Medicine Procedures |
| Common Place of Service | • 11 - Office • 81 - Independent Laboratory |
| Common Modifiers | • None • 59 - Distinct Procedural Service • TG |
| Complexity Level | Moderate |
National average reimbursement for CPT 89291 by major payers:
$950.44
$1,010.32
$1,027.47
$866.85
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 89291 | ||||||
United | 89291 | $2096.20 | 1578624466 - ROGERIO LOBO | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89291 | $2135.75 | 1063703494 - LAUREN BISHOP | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89291 | $2157.26 | 1881089464 - ASHLEY WILTSHIRE | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89291 | $2157.26 | 1194024877 - PAULA BRADY | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89291 | $2135.75 | 1578624466 - ROGERIO LOBO | 134079389 - (NY) CENTER FOR WOMENS REPRODUCTIVE CARE | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89291 | $2073.54 | 1336394436 - ANITA HOLMAN | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $2075.31 | 1720270846 - NOELIA ZORK | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 89291 | $1430.00 | 1669904520 - CCRM SAN FRANCISCO, LLC | 812194199 - (CA) BAY AREA CENTER FOR REPRODUCTIVE MEDICINE / CCRM SAN FRANCISCO LLC | CA | Ambulatory Fertility Facility (261QA0006X) |
United | 89291 | $2225.12 | 1023065158 - LISA KUMP-CHECCHIO | 135562308 - NEW YORK UNIVERSITY | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89291 | $2135.75 | 1174555874 - JODI LERNER | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 89291 | $2075.31 | 1487686861 - THOMAS SHIN | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $1577.23 | 1639163785 - BETTINA COSTELLO | 851443782 - (NH) CONCORD HOSPITAL - LACONIA | NH | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $2073.54 | 1558623637 - STEPHANIE PURISCH | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 89291 | $1846.38 | 1609882554 - STEVEN MORGAN | 222015263 - (NJ) FAMILY PLANNING CENTER OF OCEAN COUNTY INC | NJ | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $3304.81 | 1871563718 - TIMOTHY FISHER | 20222140 - MARY HITCHCOCK MEMORIAL HOSPITAL | NH | Obstetrics & Gynecology Physician (207V00000X) |
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 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 | Assisted Oocyte Fertilization, Microtechnique; Less Than Or Equal To 10 Oocytes |
| 89281-CPT | High | Assisted Oocyte Fertilization, Microtechnique; Greater Than 10 Oocytes |
| 89290-CPT | Moderate | Biopsy, Oocyte Polar Body Or Embryo Blastomere, Microtechnique (For Pre-Implantation Genetic Diagnosis); Less Than Or Equal To 5 Embryos |
| 89291-CPT | Moderate | Biopsy, Oocyte Polar Body Or Embryo Blastomere, Microtechnique (For Pre-Implantation Genetic Diagnosis); Greater Than 5 Embryos |
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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