How much does Medicare pay for CPT 84156?

Medicare allowed an average of $3.59 per service and paid $3.59 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $34.26, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 84156?

Total protein level, urine. It was billed 1,364,352 times to 783,208 Medicare beneficiaries by 1,419 providers in 2024.

Does 84156 pay differently in an office than a hospital?

Yes. The allowed amount averaged $3.59 in an office setting and $3.58 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 84156 most?

Clinical Laboratory, with 1,120,657 services from 382 clinicians. Next are Nephrology, Nurse Practitioner, Urology.

CPT 84156

Total protein level, urine

$3.59Medicare-allowed amount per service, averaged across 1,364,352 services

Providers submitted

$34.26

Asking price, not received

Medicare allowed

$3.59

The fee schedule figure

Medicare paid

$3.59

Balance is patient coinsurance

Providers submitted an average of $34.26 for this code and Medicare allowed $3.59 — 9.5× 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 $3.59 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $3.59
Hospital / facility: $3.58

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,363,918 services were billed in an office setting and 434 in a facility.

Services: 1,364,352
Beneficiaries: 783,208
Providers billing it: 1,419
Total allowed: $4,898,024

What Medicare pays for CPT 84156

Across 1,364,352 services billed by 1,419 providers to 783,208 beneficiaries, Medicare allowed an average of $3.59 per service. That is 1.7 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 84156

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	1,120,657	669,032	$3.59	382
Nephrology	95,160	46,790	$3.59	360
Nurse Practitioner	50,934	11,368	$3.60	133
Urology	31,977	21,497	$3.58	70
Internal Medicine	23,757	6,746	$3.59	139
Pathology	13,021	8,847	$3.58	39
Physician Assistant	6,844	5,552	$3.58	51
Family Practice	5,253	3,497	$3.58	87
Rheumatology	5,080	3,509	$3.55	91
Endocrinology	4,046	2,133	$3.60	13
Hematology-Oncology	2,521	1,532	$3.59	29
Obstetrics & Gynecology	1,853	798	$3.58	3
General Practice	1,278	748	$3.57	4
Gastroenterology	829	461	$3.46	1
Pediatric Medicine	316	201	$3.55	4

84156 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
Arizona	147,332	$3.60	$3.60	80
Texas	145,057	$3.60	$3.60	59
California	144,204	$3.60	$3.60	80
New Jersey	137,813	$3.60	$3.60	35
Florida	120,648	$3.60	$3.60	74
North Carolina	120,630	$3.60	$3.60	130
Georgia	51,542	$3.59	$3.60	79
Alabama	45,008	$3.59	$3.60	46
Tennessee	42,684	$3.59	$3.60	54
Ohio	39,205	$3.59	$3.60	31
New York	37,556	$3.59	$3.60	64
Kansas	35,528	$3.60	$3.60	24
Illinois	29,955	$3.59	$3.60	47
Oklahoma	24,670	$3.58	$3.60	21
Massachusetts	24,498	$3.60	$3.60	42
Washington	21,572	$3.59	$3.60	23
Maryland	15,883	$3.60	$3.60	24
South Carolina	14,575	$3.58	$3.60	74
Pennsylvania	14,157	$3.60	$3.60	12
Wisconsin	13,359	$3.52	$3.60	10
Nevada	12,877	$3.60	$3.60	5
Virginia	12,603	$3.59	$3.60	23
Missouri	10,190	$3.60	$3.60	27
Minnesota	10,033	$3.58	$3.60	72
Hawaii	9,497	$3.59	$3.60	2
Colorado	8,793	$3.59	$3.60	11
Oregon	8,488	$3.59	$3.60	21
Louisiana	7,848	$3.59	$3.60	34
Iowa	5,458	$3.58	$3.61	28
New Mexico	5,360	$3.59	$3.60	7
Michigan	5,111	$3.59	$3.60	14
Indiana	5,105	$3.59	$3.60	27
Arkansas	4,590	$3.58	$3.60	11
Mississippi	4,231	$3.58	$3.60	11
Delaware	4,156	$3.58	$3.60	9
Nebraska	3,359	$3.59	$3.60	13
South Dakota	3,142	$3.60	$3.60	9
Maine	3,119	$3.58	$3.60	7
Idaho	2,566	$3.59	$3.60	4
Kentucky	2,096	$3.55	$3.60	10
Connecticut	2,065	$3.60	$3.60	6
Utah	1,801	$3.60	$3.60	11
Alaska	1,626	$3.57	$3.60	11
Puerto Rico	1,543	$3.52	$3.60	20
North Dakota	712	$3.57	$3.60	4
West Virginia	690	$3.54	$3.60	3
U.S. Virgin Islands	455	$3.60	$3.60	2
Rhode Island	420	$3.59	$3.60	2
New Hampshire	230	$3.60	$3.60	2
Montana	225	$3.60	$3.60	1
District of Columbia	69	$3.56	$3.60	2
Wyoming	18	$3.60	$3.60	1

Related codes

84153Psa (prostate specific antigen) measurement$17.98
84100Phosphate level$4.63
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
84105Urine phosphate level$5.66

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.