How much does Medicare pay for CPT 83069?

Medicare allowed an average of $3.85 per service and paid $3.85 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $11.48, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 83069?

Urine hemoglobin level. It was billed 46,733 times to 32,204 Medicare beneficiaries by 104 providers in 2024.

Which specialty bills 83069 most?

Urology, with 32,207 services from 69 clinicians. Next are Clinical Laboratory, Physician Assistant, Nurse Practitioner.

CPT 83069

Urine hemoglobin level

$3.85Medicare-allowed amount per service, averaged across 46,733 services

Providers submitted

$11.48

Asking price, not received

Medicare allowed

$3.85

The fee schedule figure

Medicare paid

$3.85

Balance is patient coinsurance

Providers submitted an average of $11.48 for this code and Medicare allowed $3.85 — 3.0× 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 $3.85 (100%); the rest is the patient’s coinsurance and deductible.

Services: 46,733
Beneficiaries: 32,204
Providers billing it: 104
Total allowed: $179,922

What Medicare pays for CPT 83069

Across 46,733 services billed by 104 providers to 32,204 beneficiaries, Medicare allowed an average of $3.85 per service. That is 1.5 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 83069

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	32,207	21,558	$3.85	69
Clinical Laboratory	6,026	4,570	$3.86	6
Physician Assistant	4,154	3,357	$3.84	14
Nurse Practitioner	2,382	1,830	$3.86	10
Obstetrics & Gynecology	1,853	798	$3.84	3
Internal Medicine	73	54	$3.87	1
Nephrology	38	37	$3.87	1

83069 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
Georgia	8,089	$3.84	$3.87	8
Missouri	5,754	$3.87	$3.87	5
Oklahoma	5,304	$3.83	$3.87	9
Massachusetts	4,470	$3.87	$3.87	11
Delaware	4,114	$3.84	$3.87	7
Alabama	3,519	$3.84	$3.87	7
Arkansas	3,319	$3.86	$3.87	1
Florida	2,143	$3.87	$3.87	3
Maine	1,949	$3.85	$3.87	5
Alaska	1,613	$3.84	$3.87	11
Tennessee	1,187	$3.86	$3.87	10
Mississippi	1,056	$3.85	$3.87	4
Illinois	810	$3.87	$3.87	1
Louisiana	740	$3.87	$3.87	5
Ohio	716	$3.87	$3.87	6
North Carolina	667	$3.84	$3.87	4
West Virginia	530	$3.78	$3.87	1
Texas	248	$3.83	$3.87	2
Virginia	235	$3.86	$3.87	1
New Hampshire	206	$3.87	$3.87	1
Pennsylvania	40	$3.87	$3.87	1
Nevada	24	$3.87	$3.87	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
83014Administration of drug for helicobacter pylori$7.69
83020Hemoglobin analysis and measurement$14.03
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.