RxDoctor Payments Data

CPT 82085

Aldolase (enzyme) level

$9.46Medicare-allowed amount per service, averaged across 51,796 services
Providers submitted
$71.64

Asking price, not received

Medicare allowed
$9.46

The fee schedule figure

Medicare paid
$9.46

Balance is patient coinsurance

Providers submitted an average of $71.64 for this code and Medicare allowed $9.467.6× 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 $9.46 (100%); the rest is the patient’s coinsurance and deductible.

Services
51,796

Medicare Part B, 2024

Beneficiaries
42,673
Providers billing it
122
Total allowed
$489,990

Services × allowed amount

What Medicare pays for CPT 82085

Across 51,796 services billed by 122 providers to 42,673 beneficiaries, Medicare allowed an average of $9.46 per service. That is 1.2 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 82085

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory51,77742,657$9.46121
Pathology1916$9.521

82085 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
New Jersey8,075$9.50$9.528
North Carolina7,293$9.51$9.523
California5,550$9.13$9.5211
Texas5,333$9.47$9.5210
Florida5,045$9.51$9.528
Arizona2,434$9.49$9.524
Georgia2,104$9.52$9.521
Ohio1,815$9.50$9.527
Alabama1,759$9.51$9.523
Kansas1,547$9.52$9.524
New York1,472$9.51$9.526
Illinois1,143$9.52$9.522
Massachusetts1,072$9.52$9.522
Minnesota915$9.45$9.524
Tennessee835$9.47$9.523
Washington728$9.52$9.523
Utah660$9.49$9.522
Pennsylvania620$9.49$9.524
Maryland469$9.52$9.524
Hawaii417$9.48$9.522
Nevada377$9.52$9.522
Virginia373$9.48$9.523
Oklahoma351$9.52$9.523
Wisconsin314$9.50$9.523
Colorado307$9.49$9.522
Oregon144$9.52$9.523
Iowa116$9.45$9.522
New Mexico111$9.45$9.521
Indiana104$9.35$9.521
Michigan77$6.30$8.192
Kentucky44$9.15$9.522
Puerto Rico44$8.98$9.521
Maine43$9.52$9.521
Rhode Island41$9.52$9.521
Connecticut22$9.52$9.521
Wyoming16$9.52$9.521
South Dakota15$9.52$9.521
Louisiana11$9.52$9.521

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.