How much does Medicare pay for CPT 83020?

Medicare allowed an average of $14.03 per service and paid $12.65 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $130.88, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 83020?

Hemoglobin analysis and measurement, electrophoresis. It was billed 30,427 times to 26,208 Medicare beneficiaries by 243 providers in 2024.

Does 83020 pay differently in an office than a hospital?

Yes. The allowed amount averaged $13.09 in an office setting and $17.03 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 83020 most?

Clinical Laboratory, with 18,584 services from 73 clinicians. Next are Pathology, Hematology, Internal Medicine.

CPT 83020

Hemoglobin analysis and measurement, electrophoresis

$14.03Medicare-allowed amount per service, averaged across 30,427 services

Providers submitted

$130.88

Asking price, not received

Medicare allowed

$14.03

The fee schedule figure

Medicare paid

$12.65

Balance is patient coinsurance

Providers submitted an average of $130.88 for this code and Medicare allowed $14.03 — 9.3× 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 $12.65 (90%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $13.09
Hospital / facility: $17.03

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 23,153 services were billed in an office setting and 7,274 in a facility.

Services: 30,427
Beneficiaries: 26,208
Providers billing it: 243
Total allowed: $426,891

What Medicare pays for CPT 83020

Across 30,427 services billed by 243 providers to 26,208 beneficiaries, Medicare allowed an average of $14.03 per service. That is 1.2 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 83020

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	18,584	17,184	$12.62	73
Pathology	11,612	8,866	$16.26	166
Hematology	125	52	$16.93	2
Internal Medicine	89	89	$12.61	1
Pulmonary Disease	17	17	$12.61	1

83020 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	6,832	$14.58	$12.69	33
New Jersey	5,562	$12.79	$12.61	9
California	2,903	$13.11	$12.57	15
North Carolina	2,616	$13.27	$12.66	12
Texas	2,242	$13.21	$12.54	13
Alabama	1,303	$15.05	$12.56	9
New York	894	$15.89	$12.67	19
Illinois	839	$15.49	$12.90	10
Ohio	736	$14.69	$12.65	15
Georgia	672	$12.61	$12.61	1
Massachusetts	597	$15.11	$12.62	13
Michigan	593	$16.09	$12.53	14
South Carolina	527	$16.37	$12.66	1
Wisconsin	516	$14.52	$12.79	8
Pennsylvania	474	$15.74	$12.73	10
Arizona	353	$12.61	$12.61	2
Virginia	282	$14.36	$12.73	4
Kansas	250	$14.43	$12.71	4
Tennessee	250	$14.46	$12.55	4
Nevada	237	$12.61	$12.61	1
Maryland	207	$13.34	$12.68	4
Minnesota	198	$13.58	$12.50	3
Hawaii	170	$15.97	$12.93	3
Colorado	168	$16.54	$13.33	3
Missouri	116	$16.74	$12.97	2
Connecticut	113	$17.63	$13.06	2
Indiana	101	$15.19	$12.86	5
Arkansas	100	$16.09	$12.80	2
Kentucky	94	$14.90	$13.15	4
Rhode Island	93	$14.97	$11.94	2
Washington	72	$14.58	$12.19	4
Delaware	63	$17.08	$12.91	1
Vermont	58	$16.87	$11.80	2
Louisiana	42	$16.46	$12.93	1
Oklahoma	41	$12.61	$12.61	2
New Mexico	30	$12.62	$12.62	1
Mississippi	25	$16.64	$12.49	2
Oregon	24	$16.41	$13.68	1
Utah	21	$12.61	$12.61	1
Puerto Rico	13	$12.03	$12.61	1

Related codes

83036Hemoglobin a1c level$9.49
83090Homocysteine (amino acid) level$17.55
83001Gonadotropin, follicle stimulating (reproductive hormone) level$18.16
83002Gonadotropin, luteinizing (reproductive hormone) level$18.11
83010Haptoglobin (serum protein) level$12.31
83013Breath test analysis for helicobacter pylori$65.81
83037Hemoglobin a1c level$9.30
83021Hemoglobin analysis and measurement$17.69
83069Urine hemoglobin level$3.85
83014Administration of drug for helicobacter pylori$7.69
83003Human growth hormone level$16.31
83018Heavy metal level$19.57

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.