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 | Reproductive Medicine Procedures Pathology and Laboratory Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | None 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
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 89291 | $875.00 | 1164724860 - UTAH CENTER FOR REPRODUCTIVE MEDICINE | 870529461 - (UT) UNIVERSITY OF UTAH / UTAH CENTER FOR REPRODUCTIVE MEDICINE | UT | Reproductive Endocrinology Physician (207VE0102X) |
United | 89291 | $2075.31 | 1740642958 - SAMFEE DOE | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $1432.07 | 1609196344 - ANDREA PELLETIER | 10484903 - INTERMED, P.A. | ME | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $2075.31 | 1285666974 - ANITA LASALA | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 89291 | $1444.69 | 1699860270 - YORK HOSPITAL DBA COASTAL OB-GYN, LLC | 10212444 - YORK HOSPITAL | ME | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $2157.26 | 1114158383 - MATTHEW CANTOR | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $2075.31 | 1063703494 - LAUREN BISHOP | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89291 | $2073.54 | 1477757250 - TARAH PUA | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Gynecologic Oncology Physician (207VX0201X) |
United | 89291 | $2577.68 | 1053479832 - DENISE POULIN | 20354549 - CHESHIRE MEDICAL CENTER | NH | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $3304.81 | 1699782979 - MICHELLE RUSSELL | 20222140 - MARY HITCHCOCK MEMORIAL HOSPITAL | NH | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 89291 | $2096.20 | 1740430594 - JESSICA FIORELLI | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 89291 | $2096.20 | 1437242807 - ARNOLD ADVINCULA | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Gynecology Physician (207VG0400X) |
United | 89291 | $2135.75 | 1760892301 - IRIS INSOGNA | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Reproductive Endocrinology Physician (207VE0102X) |
United | 89291 | $2157.26 | 1619192911 - JUNE HOU | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | Gynecologic Oncology Physician (207VX0201X) |
United | 89291 | $2096.20 | 1578624466 - ROGERIO LOBO | 135598093 - COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK | NY | 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 89291 vs. Other Pathology and Laboratory Procedures Codes
The CPT 89291 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 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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