How much does Medicare pay for CPT 82172?

Medicare allowed an average of $20.61 per service and paid $20.61 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $38.47, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 82172?

Apolipoprotein level. It was billed 397,169 times to 248,812 Medicare beneficiaries by 314 providers in 2024.

Which specialty bills 82172 most?

Clinical Laboratory, with 343,039 services from 186 clinicians. Next are Internal Medicine, Family Practice, Endocrinology.

CPT 82172

Apolipoprotein level

$20.61Medicare-allowed amount per service, averaged across 397,169 services

Providers submitted

$38.47

Asking price, not received

Medicare allowed

$20.61

The fee schedule figure

Medicare paid

$20.61

Balance is patient coinsurance

Providers submitted an average of $38.47 for this code and Medicare allowed $20.61 — 1.9× 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 $20.61 (100%); the rest is the patient’s coinsurance and deductible.

Services: 397,169
Beneficiaries: 248,812
Providers billing it: 314
Total allowed: $8,185,653

What Medicare pays for CPT 82172

Across 397,169 services billed by 314 providers to 248,812 beneficiaries, Medicare allowed an average of $20.61 per service. That is 1.6 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 82172

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	343,039	229,431	$20.63	186
Internal Medicine	26,975	8,943	$20.55	52
Family Practice	15,456	5,397	$20.63	34
Endocrinology	5,218	1,636	$20.62	8
Nurse Practitioner	3,423	946	$20.66	10
Pathology	1,256	1,147	$20.56	4
Obstetrics & Gynecology	496	314	$20.67	2
Cardiology	482	362	$15.64	8
Physician Assistant	404	265	$20.67	4
Advanced Heart Failure and Transplant Cardiology	198	162	$9.90	1
Infectious Disease	85	85	$14.03	1
Hospitalist	50	48	$20.67	1
General Practice	31	29	$20.67	1
Interventional Cardiology	29	26	$10.17	1
Hematology-Oncology	27	21	$20.67	1

82172 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	68,587	$20.61	$20.67	52
California	58,651	$20.63	$20.67	35
New Jersey	46,905	$20.63	$20.67	27
Massachusetts	40,014	$20.66	$20.67	4
North Carolina	36,401	$20.61	$20.67	18
Texas	35,040	$20.64	$20.67	25
Ohio	22,743	$20.53	$20.55	8
Arizona	12,910	$20.64	$20.67	13
Maryland	10,459	$20.67	$20.67	11
New York	9,106	$20.67	$20.67	14
Georgia	8,605	$20.66	$20.67	3
North Dakota	6,923	$20.67	$20.67	1
Washington	6,049	$20.62	$20.67	5
Kansas	4,194	$20.67	$20.67	3
Illinois	4,064	$20.67	$20.67	3
Nevada	3,526	$20.67	$20.67	3
Colorado	2,952	$20.64	$20.67	5
Alabama	2,876	$20.59	$20.67	2
Tennessee	2,307	$20.62	$20.67	4
Pennsylvania	2,159	$20.67	$20.67	6
Oklahoma	1,925	$20.65	$20.67	5
Michigan	1,452	$20.60	$20.67	7
Virginia	1,267	$18.66	$20.67	5
Missouri	1,134	$20.64	$20.67	2
Louisiana	1,105	$16.08	$20.67	13
Oregon	1,083	$20.54	$20.67	4
South Carolina	1,049	$20.40	$20.67	9
Minnesota	926	$20.64	$20.67	4
Hawaii	765	$20.58	$20.67	2
Utah	652	$20.67	$20.67	4
Wisconsin	455	$20.58	$20.67	4
New Mexico	354	$20.49	$20.61	2
Indiana	152	$20.67	$20.67	2
Puerto Rico	71	$20.67	$20.67	2
Rhode Island	62	$20.67	$20.67	1
Kentucky	53	$20.67	$20.67	1
South Dakota	51	$20.67	$20.67	1
Iowa	45	$20.67	$20.67	1
Maine	44	$20.67	$20.67	1
Connecticut	40	$20.67	$20.67	1
Idaho	13	$20.67	$20.67	1

Related codes

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
82104Alpha-1-antitrypsin (protein) blood test$14.13
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.