RxDoctor Payments Data

CPT 83690

Lipase (fat enzyme) level

$6.74Medicare-allowed amount per service, averaged across 396,575 services
Providers submitted
$47.47

Asking price, not received

Medicare allowed
$6.74

The fee schedule figure

Medicare paid
$6.74

Balance is patient coinsurance

Providers submitted an average of $47.47 for this code and Medicare allowed $6.747.0× 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 $6.74 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$6.74
Hospital / facility
$6.75

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 396,514 services were billed in an office setting and 61 in a facility.

Services
396,575

Medicare Part B, 2024

Beneficiaries
321,211
Providers billing it
1,361
Total allowed
$2,672,916

Services × allowed amount

What Medicare pays for CPT 83690

Across 396,575 services billed by 1,361 providers to 321,211 beneficiaries, Medicare allowed an average of $6.74 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 83690

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory355,401289,388$6.74479
Internal Medicine8,7196,880$6.68196
Pathology8,2166,681$6.7146
Family Practice7,1726,268$6.71248
Cardiology3,9051,764$6.755
Nurse Practitioner3,0382,884$6.70134
Hematology-Oncology1,994855$6.7420
Gastroenterology1,9111,598$6.6940
Physician Assistant1,6401,552$6.7284
Emergency Medicine1,5801,461$6.7068
Endocrinology1,070780$6.6811
Medical Oncology825326$6.757
General Practice294272$6.717
Rheumatology237130$6.705
Hematology17973$6.601

83690 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.

StateServicesAllowedStandardized pmtProviders
California77,693$6.75$6.75136
New Jersey52,506$6.74$6.7557
Texas34,145$6.74$6.7590
Florida30,750$6.75$6.7590
North Carolina28,924$6.74$6.7586
New York21,654$6.74$6.7578
Illinois12,660$6.74$6.7558
Ohio12,298$6.73$6.7532
Tennessee12,115$6.72$6.7592
Alabama11,826$6.74$6.7531
Arizona11,663$6.73$6.7514
Massachusetts9,195$6.75$6.7548
Kansas8,270$6.75$6.7517
Georgia7,125$6.74$6.7527
Washington7,102$6.72$6.7520
Maryland6,048$6.73$6.7526
Virginia4,968$6.73$6.7526
Pennsylvania4,830$6.74$6.7517
Oklahoma3,752$6.73$6.759
Wisconsin3,739$6.53$6.7517
Colorado3,386$6.71$6.7514
South Carolina2,992$6.71$6.7562
Michigan2,919$6.75$6.7518
Minnesota2,850$6.67$6.7534
Oregon2,682$6.72$6.7516
Nevada2,395$6.74$6.756
Missouri2,214$6.73$6.7522
Hawaii2,077$6.68$6.755
Kentucky1,467$6.73$6.7520
Indiana1,408$6.73$6.7510
Mississippi1,284$6.68$6.7533
Iowa1,191$6.73$6.7518
Louisiana1,153$6.74$6.7519
Utah936$6.73$6.7511
Nebraska931$6.73$6.7516
New Mexico804$6.74$6.754
Arkansas753$6.69$6.7525
North Dakota731$6.74$6.756
Rhode Island581$6.73$6.751
South Dakota463$6.73$6.756
Puerto Rico388$6.72$6.757
Maine307$6.73$6.752
Montana293$6.71$6.759
Connecticut289$6.66$6.754
Idaho224$6.75$6.753
District of Columbia160$6.67$6.751
Wyoming111$6.70$6.756
West Virginia105$6.71$6.754
New Hampshire99$6.75$6.753
Delaware88$6.75$6.753
U.S. Virgin Islands31$6.75$6.752

Related codes

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.