How much does Medicare pay for CPT 82803?

Medicare allowed an average of $25.47 per service and paid $25.47 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $83.18, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 82803?

Blood gases measurement. It was billed 2,796 times to 2,519 Medicare beneficiaries by 59 providers in 2024.

Does 82803 pay differently in an office than a hospital?

Yes. The allowed amount averaged $25.47 in an office setting and $25.55 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 82803 most?

Pulmonary Disease, with 1,752 services from 36 clinicians. Next are Clinical Laboratory, Pathology, Cardiology.

CPT 82803

Blood gases measurement

$25.47Medicare-allowed amount per service, averaged across 2,796 services

Providers submitted

$83.18

Asking price, not received

Medicare allowed

$25.47

The fee schedule figure

Medicare paid

$25.47

Balance is patient coinsurance

Providers submitted an average of $83.18 for this code and Medicare allowed $25.47 — 3.3× 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 $25.47 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $25.47
Hospital / facility: $25.55

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 2,753 services were billed in an office setting and 43 in a facility.

Services: 2,796
Beneficiaries: 2,519
Providers billing it: 59
Total allowed: $71,214

What Medicare pays for CPT 82803

Across 2,796 services billed by 59 providers to 2,519 beneficiaries, Medicare allowed an average of $25.47 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 82803

Specialty	Services	Beneficiaries	Avg allowed	Providers
Pulmonary Disease	1,752	1,613	$25.42	36
Clinical Laboratory	440	388	$25.55	9
Pathology	216	174	$25.55	2
Cardiology	117	86	$25.55	1
Internal Medicine	100	100	$25.55	1
Emergency Medicine	66	62	$25.55	4
Nurse Practitioner	50	46	$25.55	3
Family Practice	30	26	$25.55	1
Physician Assistant	14	13	$25.55	1
Urology	11	11	$25.55	1

82803 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
California	921	$25.55	$25.55	11
Missouri	355	$25.28	$25.55	7
Maryland	314	$25.32	$25.55	6
Florida	236	$25.55	$25.55	2
Arizona	185	$25.55	$25.55	1
Virginia	156	$25.55	$25.55	6
Mississippi	112	$25.55	$25.55	6
Kansas	106	$25.55	$25.55	2
Texas	96	$25.55	$25.55	5
Oklahoma	83	$25.55	$25.55	3
South Carolina	77	$25.22	$25.55	3
New York	70	$25.15	$25.55	3
Georgia	28	$25.55	$25.55	1
Wisconsin	26	$25.55	$25.55	1
Arkansas	19	$25.55	$25.55	1
Kentucky	12	$25.55	$25.55	1

Related codes

82805Blood gases measurement$72.75

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.