RxDoctor Payments Data

CPT 80145

Measurement of adalimumab

$37.80Medicare-allowed amount per service, averaged across 1,949 services
Providers submitted
$366.62

Asking price, not received

Medicare allowed
$37.80

The fee schedule figure

Medicare paid
$37.80

Balance is patient coinsurance

Providers submitted an average of $366.62 for this code and Medicare allowed $37.809.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $37.80 (100%); the rest is the patient’s coinsurance and deductible.

Services
1,949

Medicare Part B, 2024

Beneficiaries
1,769
Providers billing it
32
Total allowed
$73,672

Services × allowed amount

What Medicare pays for CPT 80145

Across 1,949 services billed by 32 providers to 1,769 beneficiaries, Medicare allowed an average of $37.80 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 80145

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory1,9491,769$37.8032

80145 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
California617$37.80$37.807
North Carolina279$37.80$37.801
New Jersey208$37.80$37.802
Florida169$37.80$37.803
Texas125$37.80$37.804
Alabama103$37.80$37.801
Georgia76$37.80$37.801
Minnesota52$37.80$37.802
New York47$37.80$37.801
Massachusetts43$37.80$37.802
Arizona38$37.80$37.801
Ohio34$37.80$37.801
Kansas30$37.80$37.801
Illinois29$37.80$37.801
Colorado28$37.80$37.801
Washington27$37.80$37.801
Wisconsin25$37.80$37.801
Maryland19$37.80$37.801

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.