How much does Medicare pay for CPT 82104?

Medicare allowed an average of $14.13 per service and paid $14.13 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $148.77, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 82104?

Alpha-1-antitrypsin (protein) blood test, phenotype. It was billed 13,417 times to 13,276 Medicare beneficiaries by 78 providers in 2024.

Which specialty bills 82104 most?

Clinical Laboratory, with 13,267 services from 76 clinicians. Next are Pathology.

CPT 82104

Alpha-1-antitrypsin (protein) blood test, phenotype

$14.13Medicare-allowed amount per service, averaged across 13,417 services

Providers submitted

$148.77

Asking price, not received

Medicare allowed

$14.13

The fee schedule figure

Medicare paid

$14.13

Balance is patient coinsurance

Providers submitted an average of $148.77 for this code and Medicare allowed $14.13 — 10.5× 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 $14.13 (100%); the rest is the patient’s coinsurance and deductible.

Services: 13,417
Beneficiaries: 13,276
Providers billing it: 78
Total allowed: $189,582

What Medicare pays for CPT 82104

Across 13,417 services billed by 78 providers to 13,276 beneficiaries, Medicare allowed an average of $14.13 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 82104

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	13,267	13,127	$14.13	76
Pathology	150	149	$14.17	2

82104 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
Florida	1,706	$14.15	$14.17	4
North Carolina	1,637	$14.17	$14.17	2
Texas	1,404	$14.17	$14.17	5
California	1,321	$13.93	$14.17	6
New Jersey	1,289	$14.16	$14.17	4
Georgia	718	$14.17	$14.17	1
Arizona	692	$14.09	$14.17	3
Alabama	527	$14.17	$14.17	1
Ohio	477	$14.14	$14.17	6
New York	469	$14.17	$14.17	4
Kansas	467	$14.17	$14.17	3
Illinois	426	$14.17	$14.17	2
Massachusetts	259	$14.17	$14.17	2
Minnesota	255	$14.08	$14.17	3
Utah	247	$14.17	$14.17	1
Tennessee	193	$14.02	$14.17	3
Washington	177	$14.17	$14.17	2
Wisconsin	162	$14.17	$14.17	2
Colorado	156	$14.17	$14.17	3
Maryland	152	$14.17	$14.17	3
Nevada	147	$14.17	$14.17	1
Pennsylvania	135	$14.17	$14.17	3
Oklahoma	120	$14.17	$14.17	3
Virginia	82	$14.03	$14.17	3
New Mexico	67	$13.98	$14.17	1
South Dakota	43	$14.17	$14.17	1
Oregon	35	$14.17	$14.17	2
Hawaii	30	$14.17	$14.17	2
Kentucky	13	$13.19	$14.17	1
Rhode Island	11	$14.17	$14.17	1

Related codes

82172Apolipoprotein level$20.61
82150Amylase (enzyme) level$6.34
82140Ammonia level$14.27
82105Alpha-fetoprotein (afp) level$16.40
82103Alpha-1-antitrypsin (protein) blood test$13.14
82164Angiotensin l - converting enzyme (ace) level$14.25
82175Arsenic level$18.22
82180Ascorbic acid (vitamin c) level$9.68
82107Alpha-fetoprotein (afp) analysis$62.98
82139Amino acid level$16.52
82108Aluminum level$24.78
82157Androstenedione (hormone) level$28.62

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.