How much does Medicare pay for CPT 82040?

Medicare allowed an average of $4.78 per service and paid $4.78 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $16.26, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 82040?

Albumin (protein) level. It was billed 504,167 times to 358,279 Medicare beneficiaries by 1,043 providers in 2024.

Does 82040 pay differently in an office than a hospital?

Yes. The allowed amount averaged $4.78 in an office setting and $4.85 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 82040 most?

Clinical Laboratory, with 382,019 services from 337 clinicians. Next are Rheumatology, Internal Medicine, Hematology-Oncology.

CPT 82040

Albumin (protein) level

$4.78Medicare-allowed amount per service, averaged across 504,167 services

Providers submitted

$16.26

Asking price, not received

Medicare allowed

$4.78

The fee schedule figure

Medicare paid

$4.78

Balance is patient coinsurance

Providers submitted an average of $16.26 for this code and Medicare allowed $4.78 — 3.4× 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 $4.78 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $4.78
Hospital / facility: $4.85

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 504,088 services were billed in an office setting and 79 in a facility.

Services: 504,167
Beneficiaries: 358,279
Providers billing it: 1,043
Total allowed: $2,409,918

What Medicare pays for CPT 82040

Across 504,167 services billed by 1,043 providers to 358,279 beneficiaries, Medicare allowed an average of $4.78 per service. That is 1.4 services per beneficiary, so this is a code patients typically receive more than once. 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 82040

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	382,019	289,562	$4.76	337
Rheumatology	36,258	19,358	$4.83	125
Internal Medicine	26,655	15,421	$4.84	118
Hematology-Oncology	16,791	3,913	$4.82	25
Family Practice	9,073	6,179	$4.84	94
Nurse Practitioner	5,155	3,781	$4.83	82
Pathology	5,093	4,113	$4.83	34
Endocrinology	4,880	3,383	$4.83	48
Nephrology	4,388	2,744	$4.85	23
Urology	4,132	3,072	$4.83	39
Physician Assistant	3,552	2,688	$4.78	59
Cardiology	1,354	876	$4.85	4
Interventional Cardiology	1,058	482	$4.85	1
Pulmonary Disease	724	327	$4.85	2
Medical Oncology	601	330	$4.85	4

82040 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.

State	Services	Allowed	Standardized pmt	Providers
New Jersey	83,945	$4.66	$4.66	28
California	56,180	$4.82	$4.83	92
Texas	55,664	$4.83	$4.83	44
Florida	42,169	$4.81	$4.83	59
North Carolina	34,587	$4.80	$4.80	29
Ohio	22,994	$4.69	$4.70	32
Massachusetts	22,175	$4.85	$4.85	102
Indiana	18,727	$4.82	$4.85	22
Illinois	17,907	$4.81	$4.81	38
New York	15,204	$4.82	$4.83	70
Arizona	14,194	$4.56	$4.57	9
Michigan	13,098	$4.83	$4.85	25
Minnesota	11,757	$4.83	$4.85	52
Alabama	9,571	$4.80	$4.80	10
Wisconsin	8,436	$4.81	$4.85	38
Iowa	8,421	$4.81	$4.85	45
Pennsylvania	7,126	$4.83	$4.85	28
Washington	6,276	$4.78	$4.79	8
Kansas	6,067	$4.83	$4.83	11
Colorado	5,436	$4.81	$4.82	14
Georgia	4,799	$4.85	$4.85	15
South Carolina	4,789	$4.84	$4.84	45
Arkansas	3,953	$4.81	$4.85	32
Nebraska	3,933	$4.81	$4.85	13
Oklahoma	3,140	$4.41	$4.42	15
Maryland	2,990	$4.85	$4.85	13
Virginia	2,864	$4.83	$4.84	10
Louisiana	2,742	$4.82	$4.84	12
Tennessee	2,602	$4.78	$4.80	12
Mississippi	2,333	$4.81	$4.85	20
South Dakota	1,466	$4.84	$4.85	6
Nevada	1,335	$4.85	$4.85	3
Maine	1,320	$4.79	$4.79	3
Kentucky	1,224	$4.83	$4.85	7
Missouri	1,128	$4.85	$4.85	42
Rhode Island	715	$4.83	$4.85	2
Oregon	684	$4.82	$4.83	6
Hawaii	445	$4.83	$4.85	2
North Dakota	378	$4.84	$4.85	5
Connecticut	351	$4.79	$4.80	4
Utah	351	$4.85	$4.85	7
New Hampshire	332	$4.83	$4.84	3
New Mexico	125	$4.61	$4.64	3
Montana	110	$4.85	$4.85	3
Delaware	52	$4.85	$4.85	1
District of Columbia	49	$4.81	$4.81	2
Puerto Rico	23	$4.85	$4.85	1

Related codes

82043Urine microalbumin (protein) level$5.65
82044Urine microalbumin (protein) analysis$6.07
82024Adrenocorticotropic hormone (acth) level$37.74
82085Aldolase (enzyme) level$9.46
82088Aldosterone hormone level$39.58
82010Ketone bodies analysis$7.97
82075Measurement of alcohol level in breath specimen$29.02
82042Cerebrospinal fluid$7.55

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.