CPT 84105

Across 70,315 services billed by 87 providers to 56,624 beneficiaries, Medicare allowed an average of $5.66 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.

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.

• 84153Psa (prostate specific antigen) measurement$17.98
• 84100Phosphate level$4.63
• 84156Total protein level$3.59
• 84165Protein measurement$13.51
• 84155Total protein level$3.55
• 84154Psa (prostate specific antigen) measurement$18.00
• 84132Blood potassium level$4.63
• 84166Protein measurement$17.39
• 84144Progesterone (reproductive hormone) level$20.40
• 84146Prolactin (milk producing hormone) level$18.95
• 84134Prealbumin (protein) level$14.28
• 84133Urine potassium level$4.64

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.

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