RxDoctor Payments Data

CPT 84145

Procalcitonin (hormone) level

$26.66Medicare-allowed amount per service, averaged across 19,080 services
Providers submitted
$225.47

Asking price, not received

Medicare allowed
$26.66

The fee schedule figure

Medicare paid
$26.66

Balance is patient coinsurance

Providers submitted an average of $225.47 for this code and Medicare allowed $26.668.5× 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 $26.66 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$26.66
Hospital / facility
$26.68

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 18,896 services were billed in an office setting and 184 in a facility.

Services
19,080

Medicare Part B, 2024

Beneficiaries
15,160
Providers billing it
133
Total allowed
$508,673

Services × allowed amount

What Medicare pays for CPT 84145

Across 19,080 services billed by 133 providers to 15,160 beneficiaries, Medicare allowed an average of $26.66 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 84145

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory18,81214,978$26.66127
Pathology217135$26.684
Internal Medicine5147$26.682

84145 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
California3,679$26.66$26.6820
New Jersey3,040$26.68$26.687
Florida1,713$26.67$26.686
New York1,413$26.68$26.684
Illinois1,144$26.68$26.686
North Carolina906$26.66$26.682
Texas832$26.68$26.6812
Nevada824$26.67$26.683
Wisconsin605$26.56$26.684
Ohio465$26.68$26.685
Kansas418$26.65$26.685
Pennsylvania392$26.68$26.685
Tennessee349$26.63$26.683
Arizona345$26.61$26.683
Rhode Island312$26.68$26.681
Massachusetts295$26.68$26.684
Virginia277$26.68$26.683
Alabama275$26.68$26.681
Washington259$26.68$26.682
Minnesota211$26.55$26.684
Georgia191$26.68$26.682
Oklahoma129$26.68$26.685
Hawaii120$26.51$26.682
Oregon106$26.68$26.683
Guam104$26.68$26.681
Nebraska103$26.45$26.682
Maryland80$26.68$26.682
Iowa74$26.68$26.682
Louisiana70$26.68$26.681
South Dakota61$26.68$26.681
Colorado46$26.68$26.682
Utah36$26.68$26.681
Michigan30$26.68$26.681
New Mexico29$25.81$26.681
Connecticut27$26.68$26.681
Idaho27$26.68$26.681
Indiana26$26.68$26.681
North Dakota20$26.25$26.681
Missouri20$26.68$26.681
South Carolina14$26.68$26.681
Kentucky13$26.68$26.681

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.