How much does Medicare pay for CPT 83630?

Medicare allowed an average of $19.26 per service and paid $19.26 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $115.19, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 83630?

Stool lactoferrin (immune system protein) analysis. It was billed 9,058 times to 8,725 Medicare beneficiaries by 103 providers in 2024.

Which specialty bills 83630 most?

Clinical Laboratory, with 8,518 services from 84 clinicians. Next are Nurse Practitioner, Pathology, Gastroenterology.

CPT 83630

Stool lactoferrin (immune system protein) analysis

$19.26Medicare-allowed amount per service, averaged across 9,058 services

Providers submitted

$115.19

Asking price, not received

Medicare allowed

$19.26

The fee schedule figure

Medicare paid

$19.26

Balance is patient coinsurance

Providers submitted an average of $115.19 for this code and Medicare allowed $19.26 — 6.0× 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 $19.26 (100%); the rest is the patient’s coinsurance and deductible.

Services: 9,058
Beneficiaries: 8,725
Providers billing it: 103
Total allowed: $174,457

What Medicare pays for CPT 83630

Across 9,058 services billed by 103 providers to 8,725 beneficiaries, Medicare allowed an average of $19.26 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 83630

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	8,518	8,208	$19.27	84
Nurse Practitioner	156	153	$18.89	5
Pathology	135	126	$19.31	3
Gastroenterology	123	116	$19.15	5
Family Practice	59	59	$19.31	2
Physician Assistant	25	25	$18.54	1
Internal Medicine	24	23	$19.31	2
Hematology-Oncology	18	15	$19.31	1

83630 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	1,555	$19.29	$19.31	5
California	1,401	$19.31	$19.31	14
North Carolina	768	$19.31	$19.31	2
Florida	675	$19.31	$19.31	6
Arizona	626	$19.28	$19.31	2
Texas	458	$19.31	$19.31	8
New York	453	$19.24	$19.31	3
Wisconsin	439	$19.10	$19.31	3
Tennessee	306	$18.92	$19.31	7
Virginia	291	$19.31	$19.31	4
Illinois	240	$19.31	$19.31	5
Kentucky	234	$19.08	$19.31	5
Washington	211	$19.31	$19.31	2
Ohio	194	$19.12	$19.31	5
Utah	169	$19.31	$19.31	4
Hawaii	140	$18.97	$19.31	2
Missouri	123	$19.31	$19.31	1
Pennsylvania	93	$19.31	$19.31	2
Massachusetts	91	$19.31	$19.31	3
Oregon	72	$19.12	$19.31	2
Minnesota	61	$19.31	$19.31	2
Louisiana	60	$19.31	$19.31	1
South Carolina	53	$19.31	$19.31	1
Maryland	45	$19.31	$19.31	2
Indiana	41	$19.31	$19.31	1
New Mexico	38	$19.31	$19.31	1
Nevada	35	$19.31	$19.31	1
Mississippi	35	$19.31	$19.31	1
Alabama	26	$19.31	$19.31	1
North Dakota	22	$19.31	$19.31	1
Idaho	21	$19.31	$19.31	1
Kansas	20	$19.31	$19.31	1
Michigan	19	$19.31	$19.31	1
South Dakota	18	$19.31	$19.31	1
Iowa	14	$19.31	$19.31	1
Oklahoma	11	$19.31	$19.31	1

Related codes

83615Lactate dehydrogenase (enzyme) level$5.89
83690Lipase (fat enzyme) level$6.74
83695Lipoprotein (a) level$13.99
83698Lipoprotein-associated phospholipase a2 (enzyme) level$45.28
83625Lactate dehydrogenase (enzyme) measurement$12.53
83655Lead level$11.84
83605Lactic acid level$11.31
83631Stool lactoferrin (immune system protein) level$19.22

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.