How much does Medicare pay for CPT 82565?

Medicare allowed an average of $4.89 per service and paid $4.89 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $22.70, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 82565?

Blood creatinine level. It was billed 1,120,881 times to 798,529 Medicare beneficiaries by 4,595 providers in 2024.

Does 82565 pay differently in an office than a hospital?

Yes. The allowed amount averaged $4.89 in an office setting and $5.02 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 82565 most?

Clinical Laboratory, with 711,732 services from 461 clinicians. Next are Rheumatology, Diagnostic Radiology, Internal Medicine.

CPT 82565

Blood creatinine level

$4.89Medicare-allowed amount per service, averaged across 1,120,881 services

Providers submitted

$22.70

Asking price, not received

Medicare allowed

$4.89

The fee schedule figure

Medicare paid

$4.89

Balance is patient coinsurance

Providers submitted an average of $22.70 for this code and Medicare allowed $4.89 — 4.6× 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 $4.89 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $4.89
Hospital / facility: $5.02

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 1,120,834 services were billed in an office setting and 47 in a facility.

Services: 1,120,881
Beneficiaries: 798,529
Providers billing it: 4,595
Total allowed: $5,481,108

What Medicare pays for CPT 82565

Across 1,120,881 services billed by 4,595 providers to 798,529 beneficiaries, Medicare allowed an average of $4.89 per service. That is 1.4 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 82565

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	711,732	504,813	$4.83	461
Rheumatology	90,784	47,464	$4.99	277
Diagnostic Radiology	76,406	74,260	$5.00	877
Internal Medicine	44,620	30,793	$5.00	429
Family Practice	40,748	26,420	$5.01	421
Hematology-Oncology	31,346	15,393	$5.00	248
Pathology	27,386	21,239	$5.01	85
Urology	20,128	18,450	$4.99	415
Nurse Practitioner	17,024	13,450	$4.99	362
Physician Assistant	12,076	9,752	$4.98	244
Endocrinology	9,502	6,200	$5.00	76
Cardiology	7,990	6,800	$5.00	139
Nephrology	4,005	2,085	$5.02	19
Medical Oncology	3,224	2,366	$4.99	70
Interventional Cardiology	2,575	1,930	$5.00	40

82565 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	123,796	$4.92	$4.93	279
California	118,786	$4.98	$4.99	199
Texas	98,152	$4.80	$4.81	345
North Carolina	94,325	$4.74	$4.75	270
New Jersey	78,525	$4.59	$4.59	81
Massachusetts	62,163	$5.02	$5.02	446
Minnesota	56,002	$5.00	$5.02	352
Ohio	47,234	$4.84	$4.85	77
Illinois	40,236	$4.99	$5.00	173
Arizona	31,890	$4.84	$4.84	67
New York	30,061	$4.99	$5.01	194
Alabama	28,810	$4.69	$4.71	90
Iowa	24,454	$5.00	$5.02	160
Tennessee	23,880	$4.97	$5.01	248
Wisconsin	22,104	$4.94	$5.01	146
South Carolina	21,030	$4.95	$4.96	89
Pennsylvania	20,509	$5.00	$5.02	56
Mississippi	15,630	$4.98	$5.02	110
Washington	15,343	$4.93	$4.96	70
Arkansas	15,128	$5.00	$5.02	124
Kansas	15,038	$4.85	$4.86	68
Colorado	13,846	$4.78	$4.81	40
Georgia	13,803	$5.01	$5.02	86
Maryland	12,465	$5.00	$5.02	36
Virginia	12,388	$4.99	$5.01	63
Michigan	11,614	$4.98	$4.99	53
Indiana	11,468	$4.99	$5.02	75
Missouri	9,729	$4.99	$5.02	152
Nebraska	7,228	$4.99	$5.02	62
Hawaii	6,869	$4.93	$5.02	10
Oklahoma	4,629	$4.69	$4.70	45
Nevada	4,196	$5.01	$5.02	9
Kentucky	4,085	$4.97	$5.02	50
South Dakota	3,710	$5.01	$5.02	47
Louisiana	3,650	$4.93	$4.94	31
Rhode Island	3,601	$5.01	$5.02	4
Oregon	3,225	$4.96	$5.00	37
Utah	2,071	$5.00	$5.02	28
New Mexico	1,822	$4.98	$5.01	18
New Hampshire	1,541	$4.97	$4.99	7
North Dakota	1,052	$5.00	$5.02	12
Connecticut	1,010	$4.97	$4.99	8
Puerto Rico	727	$5.00	$5.00	11
Maine	591	$4.87	$4.95	12
Alaska	527	$4.96	$5.02	12
West Virginia	425	$5.01	$5.02	9
Idaho	399	$5.00	$5.02	5
District of Columbia	316	$5.01	$5.01	4
Wyoming	295	$4.99	$5.02	14
XX	201	$5.02	$5.02	1
Montana	134	$5.02	$5.02	4
Delaware	110	$5.02	$5.02	4
Vermont	58	$5.02	$5.02	2

Related codes

82570Creatinine level to test for kidney function or muscle injury$5.06
82550Creatine kinase (cardiac enzyme) level$6.37
82533Cortisol (hormone) measurement$15.94
82542Chemical analysis$23.53
82523Collagen cross links test$18.30
82525Copper level$12.12
82507Citrate level$27.22
82530Cortisol (hormone) measurement$16.35
82553Creatine kinase (cardiac enzyme) level$11.29
82575Creatinine clearance measurement to test for kidney function$9.19
82552Creatine kinase (cardiac enzyme) level$13.09
82595Cryoglobulin (protein) measurement$6.34

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.