How much does Medicare pay for CPT 83540?

Medicare allowed an average of $6.33 per service and paid $6.33 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $33.03, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 83540?

Iron level. It was billed 3,526,157 times to 2,341,722 Medicare beneficiaries by 8,692 providers in 2024.

Does 83540 pay differently in an office than a hospital?

Yes. The allowed amount averaged $6.33 in an office setting and $6.34 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 83540 most?

Clinical Laboratory, with 2,568,205 services from 651 clinicians. Next are Hematology-Oncology, Internal Medicine, Pathology.

CPT 83540

Iron level

$6.33Medicare-allowed amount per service, averaged across 3,526,157 services

Providers submitted

$33.03

Asking price, not received

Medicare allowed

$6.33

The fee schedule figure

Medicare paid

$6.33

Balance is patient coinsurance

Providers submitted an average of $33.03 for this code and Medicare allowed $6.33 — 5.2× 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 $6.33 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $6.33
Hospital / facility: $6.34

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 3,525,650 services were billed in an office setting and 507 in a facility.

Services: 3,526,157
Beneficiaries: 2,341,722
Providers billing it: 8,692
Total allowed: $22,320,574

What Medicare pays for CPT 83540

Across 3,526,157 services billed by 8,692 providers to 2,341,722 beneficiaries, Medicare allowed an average of $6.33 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 83540

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	2,568,205	1,762,146	$6.33	651
Hematology-Oncology	295,910	156,975	$6.31	1,030
Internal Medicine	170,709	118,142	$6.32	2,238
Pathology	168,442	88,241	$6.33	54
Family Practice	93,966	70,566	$6.31	1,845
Medical Oncology	67,928	35,823	$6.31	332
Nurse Practitioner	53,392	39,475	$6.31	1,194
Nephrology	26,030	16,337	$6.32	302
Physician Assistant	19,915	14,701	$6.31	501
Endocrinology	15,319	8,861	$6.32	92
Rheumatology	9,992	6,389	$6.31	106
Cardiology	9,976	6,062	$6.33	39
Gastroenterology	6,696	5,011	$6.27	120
Hematology	6,536	3,249	$6.30	20
General Practice	2,516	1,896	$6.31	29

83540 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
New Jersey	466,581	$6.33	$6.34	153
Florida	462,616	$6.33	$6.34	637
California	431,523	$6.33	$6.34	345
Texas	285,162	$6.33	$6.34	914
New York	263,494	$6.33	$6.34	730
North Carolina	233,673	$6.33	$6.34	563
Arizona	115,410	$6.33	$6.34	159
Tennessee	108,172	$6.31	$6.34	782
Ohio	107,196	$6.33	$6.34	237
Illinois	100,553	$6.33	$6.34	306
Alabama	99,263	$6.32	$6.34	258
Massachusetts	80,249	$6.34	$6.34	309
Georgia	77,975	$6.33	$6.34	299
Kansas	75,598	$6.34	$6.34	85
Virginia	68,689	$6.32	$6.34	325
Maryland	68,320	$6.33	$6.34	159
Pennsylvania	51,363	$6.33	$6.34	104
Washington	48,869	$6.32	$6.34	154
Nevada	36,034	$6.32	$6.34	57
South Carolina	31,035	$6.31	$6.34	222
Oklahoma	25,005	$6.32	$6.34	47
Wisconsin	23,458	$6.27	$6.34	49
Michigan	23,345	$6.33	$6.34	103
Colorado	21,677	$6.32	$6.34	70
Arkansas	20,998	$6.30	$6.34	154
Indiana	20,861	$6.32	$6.34	76
Oregon	20,519	$6.32	$6.34	122
Minnesota	17,325	$6.31	$6.34	185
Kentucky	13,755	$6.32	$6.34	78
Louisiana	13,733	$6.32	$6.34	91
Iowa	12,929	$6.32	$6.34	163
Hawaii	12,026	$6.32	$6.34	2
Missouri	11,288	$6.31	$6.34	132
Mississippi	10,968	$6.27	$6.34	83
Utah	10,643	$6.31	$6.34	129
North Dakota	8,622	$6.34	$6.34	18
New Mexico	8,440	$6.30	$6.34	24
South Dakota	7,192	$6.33	$6.34	50
Nebraska	6,452	$6.32	$6.34	48
Connecticut	5,099	$6.31	$6.34	59
Maine	4,776	$6.31	$6.34	52
Rhode Island	4,489	$6.32	$6.34	4
West Virginia	2,073	$6.29	$6.34	17
Idaho	1,469	$6.32	$6.34	16
New Hampshire	1,469	$6.33	$6.34	36
Delaware	1,400	$6.33	$6.34	3
Wyoming	1,140	$6.31	$6.34	28
Puerto Rico	832	$6.32	$6.34	22
Montana	759	$6.33	$6.34	5
Alaska	685	$6.26	$6.34	15
District of Columbia	580	$6.33	$6.34	8
U.S. Virgin Islands	324	$6.34	$6.34	3
Vermont	51	$6.34	$6.34	2

Related codes

83550Iron binding capacity$8.55
83521Measurement of immunoglobulin light chains$16.90
83520Measurement of substance$16.87
83516Analysis of substance$11.28
83525Insulin measurement$11.18
83519Measurement of substance$18.00
83529Measurement of interleukin-6$16.91
83518Analysis of substance$9.43
83527Insulin measurement$12.66

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.