CPT 82043

Across 4,427,155 services billed by 11,597 providers to 3,360,224 beneficiaries, Medicare allowed an average of $5.65 per service. That is 1.3 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.

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.

• 82040Albumin (protein) level$4.78
• 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

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.

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