How much does Medicare pay for CPT 84311?

Medicare allowed an average of $7.91 per service and paid $7.91 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $23.05, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 84311?

Chemical analysis using spectrophotometry (light). It was billed 86,778 times to 41,893 Medicare beneficiaries by 143 providers in 2024.

Which specialty bills 84311 most?

Urology, with 50,252 services from 69 clinicians. Next are Clinical Laboratory, Physician Assistant, Nurse Practitioner.

CPT 84311

Chemical analysis using spectrophotometry (light)

$7.91Medicare-allowed amount per service, averaged across 86,778 services

Providers submitted

$23.05

Asking price, not received

Medicare allowed

$7.91

The fee schedule figure

Medicare paid

$7.91

Balance is patient coinsurance

Providers submitted an average of $23.05 for this code and Medicare allowed $7.91 — 2.9× 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 $7.91 (100%); the rest is the patient’s coinsurance and deductible.

Services: 86,778
Beneficiaries: 41,893
Providers billing it: 143
Total allowed: $686,414

What Medicare pays for CPT 84311

Across 86,778 services billed by 143 providers to 41,893 beneficiaries, Medicare allowed an average of $7.91 per service. That is 2.1 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 84311

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	50,252	21,465	$7.90	69
Clinical Laboratory	23,220	14,303	$7.93	43
Physician Assistant	5,162	3,374	$7.88	14
Nurse Practitioner	4,489	1,827	$7.93	10
Obstetrics & Gynecology	3,324	798	$7.88	3
Internal Medicine	146	54	$7.94	1
Interventional Pain Management	129	23	$7.94	1
Nephrology	40	38	$7.94	1
Physical Medicine and Rehabilitation	16	11	$6.38	1

84311 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
North Carolina	11,523	$7.93	$7.94	7
Missouri	11,057	$7.94	$7.94	5
Georgia	10,892	$7.87	$7.94	10
Massachusetts	8,471	$7.94	$7.94	14
Delaware	8,219	$7.89	$7.94	7
Alabama	6,934	$7.88	$7.94	7
Arkansas	6,636	$7.91	$7.94	1
Oklahoma	5,474	$7.86	$7.94	11
Florida	4,380	$7.94	$7.94	5
Maine	1,950	$7.90	$7.94	5
Illinois	1,646	$7.94	$7.94	2
Alaska	1,630	$7.87	$7.94	11
Louisiana	1,483	$7.94	$7.94	5
Ohio	1,228	$7.94	$7.94	6
Tennessee	1,198	$7.91	$7.94	10
Mississippi	1,060	$7.90	$7.94	4
West Virginia	1,058	$7.75	$7.94	1
New Hampshire	410	$7.94	$7.94	1
Texas	293	$7.88	$7.94	4
California	287	$7.87	$7.94	6
Virginia	248	$7.91	$7.94	2
New York	157	$7.94	$7.94	3
New Jersey	118	$7.94	$7.94	3
Nevada	102	$7.94	$7.94	2
Oregon	85	$7.94	$7.94	1
Pennsylvania	62	$7.94	$7.94	2
Arizona	62	$7.94	$7.94	2
Utah	35	$7.94	$7.94	1
Kansas	24	$7.94	$7.94	1
South Carolina	16	$6.38	$7.94	1
Minnesota	15	$7.94	$7.94	1
Colorado	13	$7.94	$7.94	1
Washington	12	$7.94	$7.94	1

Related codes

84300Urine sodium level$4.96
84392Urine sulfate (acid) level$5.38
84305Somatomedin (growth factor) level$20.79
84378Carbohydrate analysis$11.29

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.