RxDoctor Payments Data

CPT 82465

Cholesterol level

$4.25Medicare-allowed amount per service, averaged across 89,721 services
Providers submitted
$31.43

Asking price, not received

Medicare allowed
$4.25

The fee schedule figure

Medicare paid
$4.25

Balance is patient coinsurance

Providers submitted an average of $31.43 for this code and Medicare allowed $4.257.4× 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 $4.25 (100%); the rest is the patient’s coinsurance and deductible.

Services
89,721

Medicare Part B, 2024

Beneficiaries
69,618
Providers billing it
370
Total allowed
$381,314

Services × allowed amount

What Medicare pays for CPT 82465

Across 89,721 services billed by 370 providers to 69,618 beneficiaries, Medicare allowed an average of $4.25 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.

Who bills 82465

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory69,62154,770$4.25197
Urology5,4893,017$4.268
Family Practice4,4193,705$4.2559
Internal Medicine4,2043,221$4.2551
Pathology3,5372,954$4.269
Nurse Practitioner862709$4.2618
Cardiology525424$4.262
Gastroenterology409242$4.263
Physician Assistant154144$4.264
General Practice123103$4.263
Nephrology10393$4.263
Hematology-Oncology7978$4.216
Rheumatology5836$4.261
Emergency Medicine5142$4.261
Pulmonary Disease3025$4.261

82465 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
California16,579$4.26$4.2651
Florida12,147$4.26$4.2624
New Jersey10,102$4.24$4.2411
Arizona6,731$4.24$4.247
Minnesota5,740$4.26$4.267
North Carolina4,827$4.25$4.269
New York3,484$4.25$4.2723
Ohio2,672$4.25$4.2621
Texas2,548$4.25$4.2614
Mississippi2,258$4.26$4.266
Pennsylvania2,202$4.26$4.2615
Kansas2,138$4.26$4.2616
Georgia1,930$4.26$4.265
Massachusetts1,769$4.26$4.269
Virginia1,744$4.25$4.2612
Illinois1,652$4.26$4.2612
Oklahoma1,494$4.26$4.289
Tennessee1,295$4.26$4.2613
Alabama1,182$4.25$4.2513
Maryland1,098$4.25$4.265
Michigan1,017$4.26$4.2610
Missouri983$4.22$4.2611
Iowa936$4.26$4.2610
Washington672$4.26$4.264
South Dakota400$4.23$4.266
Wisconsin342$4.25$4.267
Nebraska236$4.24$4.263
Hawaii227$4.26$4.262
Nevada203$4.26$4.262
Indiana199$4.26$4.267
Colorado198$4.25$4.263
North Dakota110$4.19$4.261
Kentucky107$4.26$4.264
Rhode Island104$4.26$4.261
Utah86$4.26$4.264
Arkansas75$4.16$4.263
Louisiana68$4.26$4.262
South Carolina59$4.26$4.263
Oregon34$4.05$4.262
U.S. Virgin Islands28$4.26$4.261
New Mexico24$4.26$4.261
Puerto Rico21$4.16$4.161

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.