How much does Medicare pay for CPT 83721?

Medicare allowed an average of $10.27 per service and paid $10.27 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $52.17, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 83721?

Ldl cholesterol level. It was billed 552,661 times to 412,593 Medicare beneficiaries by 1,390 providers in 2024.

Does 83721 pay differently in an office than a hospital?

Yes. The allowed amount averaged $10.27 in an office setting and $10.29 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 83721 most?

Clinical Laboratory, with 371,480 services from 262 clinicians. Next are Internal Medicine, Family Practice, Endocrinology.

CPT 83721

Ldl cholesterol level

$10.27Medicare-allowed amount per service, averaged across 552,661 services

Providers submitted

$52.17

Asking price, not received

Medicare allowed

$10.27

The fee schedule figure

Medicare paid

$10.27

Balance is patient coinsurance

Providers submitted an average of $52.17 for this code and Medicare allowed $10.27 — 5.1× 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 $10.27 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $10.27
Hospital / facility: $10.29

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 552,642 services were billed in an office setting and 19 in a facility.

Services: 552,661
Beneficiaries: 412,593
Providers billing it: 1,390
Total allowed: $5,675,828

What Medicare pays for CPT 83721

Across 552,661 services billed by 1,390 providers to 412,593 beneficiaries, Medicare allowed an average of $10.27 per service. That is 1.3 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 83721

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	371,480	289,861	$10.28	262
Internal Medicine	76,750	51,017	$10.26	384
Family Practice	55,230	40,552	$10.24	401
Endocrinology	26,125	14,254	$10.23	85
Nurse Practitioner	5,804	4,317	$10.25	98
Physician Assistant	4,720	3,301	$10.23	64
Cardiology	4,467	2,915	$10.26	21
Pathology	2,180	1,850	$10.26	17
Rheumatology	1,495	1,240	$10.26	19
Geriatric Medicine	1,133	823	$10.28	3
Nephrology	750	407	$10.29	5
Emergency Medicine	544	329	$10.23	3
Urology	363	327	$10.29	1
Interventional Cardiology	308	278	$10.14	6
Hematology-Oncology	291	259	$10.25	2

83721 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 York	83,292	$10.29	$10.29	73
Florida	71,528	$10.28	$10.29	158
New Jersey	64,052	$10.28	$10.29	40
California	62,045	$10.27	$10.29	100
Texas	31,617	$10.27	$10.29	83
Massachusetts	22,982	$10.28	$10.29	44
North Carolina	19,973	$10.28	$10.29	67
Washington	18,801	$10.28	$10.29	31
Georgia	16,295	$10.23	$10.29	41
Ohio	15,358	$10.26	$10.29	94
Michigan	10,504	$10.29	$10.29	18
Pennsylvania	10,352	$10.27	$10.29	27
Kansas	9,858	$10.29	$10.29	13
Arizona	9,449	$10.28	$10.29	13
Kentucky	8,985	$10.21	$10.29	47
Virginia	8,981	$10.26	$10.29	52
Oregon	8,950	$10.23	$10.29	51
South Carolina	7,616	$10.26	$10.29	30
Oklahoma	6,127	$10.27	$10.29	31
Alabama	5,700	$10.20	$10.29	27
Tennessee	5,649	$10.26	$10.29	43
Illinois	5,601	$10.28	$10.29	16
Iowa	5,331	$10.26	$10.29	27
Mississippi	5,142	$10.16	$10.29	15
Maryland	4,127	$10.28	$10.29	7
Missouri	4,073	$10.25	$10.29	47
Colorado	3,617	$10.27	$10.29	19
Indiana	3,544	$10.26	$10.29	26
Rhode Island	3,207	$10.28	$10.29	4
Nevada	2,794	$10.27	$10.29	3
New Mexico	2,757	$10.18	$10.29	10
Wisconsin	2,643	$10.15	$10.29	8
Arkansas	2,302	$10.23	$10.29	17
Utah	2,191	$10.20	$10.29	40
South Dakota	1,811	$10.25	$10.29	9
Minnesota	1,393	$10.19	$10.29	26
Louisiana	1,310	$10.28	$10.29	6
Nebraska	735	$10.28	$10.29	5
Hawaii	724	$10.28	$10.29	2
New Hampshire	282	$10.29	$10.29	1
Idaho	217	$10.25	$10.29	4
Montana	183	$10.29	$10.29	3
Alaska	172	$10.06	$10.29	3
District of Columbia	145	$10.15	$10.29	1
Maine	108	$10.29	$10.29	2
North Dakota	92	$10.19	$10.29	3
West Virginia	33	$10.29	$10.29	2
Connecticut	13	$10.29	$10.29	1

Related codes

83735Magnesium level$6.55
83704Lipoprotein level$33.38
83718Hdl cholesterol level$8.02
83789Mass spectrometry (laboratory testing method)$23.60
83722Measurement of small dense low density lipoprotein cholesterol$33.39
83785Manganese (heavy metal) level$26.11
83719Vldl cholesterol level$12.46
83700Lipoprotein level$11.02
83701Lipoprotein measurement$33.08

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.