How much does Medicare pay for CPT 83698?

Medicare allowed an average of $45.28 per service and paid $45.28 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $73.13, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 83698?

Lipoprotein-associated phospholipase a2 (enzyme) level. It was billed 108,127 times to 88,891 Medicare beneficiaries by 79 providers in 2024.

Which specialty bills 83698 most?

Clinical Laboratory, with 107,924 services from 74 clinicians. Next are Internal Medicine, Family Practice, General Practice.

CPT 83698

Lipoprotein-associated phospholipase a2 (enzyme) level

$45.28Medicare-allowed amount per service, averaged across 108,127 services

Providers submitted

$73.13

Asking price, not received

Medicare allowed

$45.28

The fee schedule figure

Medicare paid

$45.28

Balance is patient coinsurance

Providers submitted an average of $73.13 for this code and Medicare allowed $45.28 — 1.6× 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 $45.28 (100%); the rest is the patient’s coinsurance and deductible.

Services: 108,127
Beneficiaries: 88,891
Providers billing it: 79
Total allowed: $4,895,991

What Medicare pays for CPT 83698

Across 108,127 services billed by 79 providers to 88,891 beneficiaries, Medicare allowed an average of $45.28 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 83698

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	107,924	88,695	$45.28	74
Internal Medicine	92	90	$45.38	1
Family Practice	81	78	$45.38	3
General Practice	30	28	$45.38	1

83698 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
Ohio	21,560	$45.05	$45.38	3
Massachusetts	18,208	$45.38	$45.38	3
Florida	17,218	$45.38	$45.38	6
California	12,298	$45.38	$45.38	10
Arizona	5,864	$45.32	$45.38	2
Texas	5,187	$45.38	$45.38	12
North Dakota	4,365	$45.38	$45.38	1
Georgia	4,312	$45.38	$45.38	1
New Jersey	3,513	$45.36	$45.38	6
North Carolina	3,305	$45.25	$45.38	3
Kansas	2,853	$44.76	$45.38	2
Illinois	2,381	$45.38	$45.38	1
Pennsylvania	1,448	$45.38	$45.38	4
Maryland	1,441	$45.38	$45.38	1
Washington	1,221	$45.38	$45.38	2
Nevada	1,018	$45.38	$45.38	1
New York	769	$45.36	$45.38	5
Colorado	440	$45.38	$45.38	2
Oklahoma	202	$45.38	$45.38	2
South Carolina	190	$45.38	$45.38	1
Alabama	138	$45.37	$45.38	1
Tennessee	61	$45.38	$45.38	2
Utah	36	$45.38	$45.38	2
New Mexico	36	$45.38	$45.38	2
Virginia	34	$34.94	$45.38	2
Wisconsin	16	$45.38	$45.38	1
Indiana	13	$45.38	$45.38	1

Related codes

83615Lactate dehydrogenase (enzyme) level$5.89
83690Lipase (fat enzyme) level$6.74
83695Lipoprotein (a) level$13.99
83625Lactate dehydrogenase (enzyme) measurement$12.53
83655Lead level$11.84
83605Lactic acid level$11.31
83631Stool lactoferrin (immune system protein) level$19.22
83630Stool lactoferrin (immune system protein) analysis$19.26

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.