How much does Medicare pay for CPT 84460?

Medicare allowed an average of $5.15 per service and paid $5.15 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $48.42, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 84460?

Liver enzyme (sgpt), level. It was billed 1,137,784 times to 556,171 Medicare beneficiaries by 1,943 providers in 2024.

Does 84460 pay differently in an office than a hospital?

Yes. The allowed amount averaged $5.15 in an office setting and $5.19 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 84460 most?

Clinical Laboratory, with 920,887 services from 364 clinicians. Next are Internal Medicine, Rheumatology, Family Practice.

CPT 84460

Liver enzyme (sgpt), level

$5.15Medicare-allowed amount per service, averaged across 1,137,784 services

Providers submitted

$48.42

Asking price, not received

Medicare allowed

$5.15

The fee schedule figure

Medicare paid

$5.15

Balance is patient coinsurance

Providers submitted an average of $48.42 for this code and Medicare allowed $5.15 — 9.4× 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 $5.15 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $5.15
Hospital / facility: $5.19

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 1,137,720 services were billed in an office setting and 64 in a facility.

Services: 1,137,784
Beneficiaries: 556,171
Providers billing it: 1,943
Total allowed: $5,859,588

What Medicare pays for CPT 84460

Across 1,137,784 services billed by 1,943 providers to 556,171 beneficiaries, Medicare allowed an average of $5.15 per service. That is 2.0 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 84460

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	920,887	422,685	$5.15	364
Internal Medicine	54,551	36,628	$5.18	423
Rheumatology	52,379	26,983	$5.17	174
Family Practice	47,702	32,531	$5.17	410
Hematology-Oncology	16,769	3,965	$5.16	14
Pathology	9,338	6,869	$5.18	50
Nurse Practitioner	8,787	7,138	$5.17	181
Physician Assistant	6,639	5,133	$5.15	122
Cardiology	5,244	3,996	$5.17	61
Endocrinology	3,926	2,374	$5.17	31
Interventional Cardiology	3,316	2,425	$5.17	28
Urology	1,260	815	$5.14	5
Ophthalmology	836	230	$5.18	2
Nephrology	779	584	$5.19	7
Pulmonary Disease	724	327	$5.19	2

84460 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
Florida	343,003	$5.18	$5.19	88
California	210,399	$5.18	$5.18	125
New Jersey	89,566	$5.01	$5.01	19
Texas	52,945	$5.18	$5.19	47
Massachusetts	45,811	$5.15	$5.16	228
North Carolina	35,573	$5.17	$5.18	41
Ohio	32,861	$5.17	$5.17	78
Minnesota	31,982	$5.17	$5.19	239
Indiana	23,482	$5.17	$5.19	37
New York	22,566	$5.16	$5.17	95
Michigan	19,559	$5.17	$5.19	35
Illinois	19,125	$5.14	$5.16	85
Iowa	18,384	$5.16	$5.19	99
Arizona	18,259	$4.93	$4.94	8
Wisconsin	15,786	$5.16	$5.19	118
Pennsylvania	15,625	$5.17	$5.19	32
Hawaii	15,134	$5.15	$5.19	9
Alabama	12,992	$5.17	$5.18	14
Georgia	10,499	$5.18	$5.19	33
Virginia	9,981	$5.17	$5.19	34
Tennessee	9,959	$5.16	$5.18	38
Kansas	9,251	$5.18	$5.19	19
Mississippi	8,842	$5.15	$5.19	37
Colorado	8,480	$5.17	$5.19	20
South Carolina	7,466	$5.18	$5.19	61
Louisiana	6,634	$5.15	$5.17	52
Washington	6,337	$5.13	$5.15	18
Arkansas	5,325	$5.17	$5.19	22
Maryland	5,227	$5.17	$5.19	16
Rhode Island	4,124	$5.18	$5.19	1
New Hampshire	3,206	$5.18	$5.19	31
Missouri	3,171	$5.18	$5.19	60
Oklahoma	2,945	$4.69	$4.72	8
Nebraska	2,886	$5.13	$5.19	11
Kentucky	1,967	$5.13	$5.19	11
Nevada	1,708	$5.19	$5.19	3
Connecticut	1,106	$5.18	$5.19	14
South Dakota	1,090	$5.16	$5.19	9
New Mexico	1,078	$5.15	$5.17	3
Oregon	842	$5.06	$5.11	7
Puerto Rico	764	$5.07	$5.07	12
Maine	542	$5.09	$5.12	4
North Dakota	520	$5.13	$5.19	8
Utah	324	$5.16	$5.19	5
Delaware	195	$5.19	$5.19	2
Montana	143	$5.19	$5.19	2
Vermont	44	$5.19	$5.19	2
Idaho	32	$5.19	$5.19	1
District of Columbia	31	$5.19	$5.19	1
West Virginia	13	$5.19	$5.19	1

Related codes

84443Blood test, thyroid stimulating hormone (tsh)$16.44
84439Thyroxine (thyroid chemical)$8.83
84481Thyroid hormone$16.57
84403Testosterone (hormone) level$25.20
84436Thyroxine (thyroid chemical)$6.73
84450Liver enzyme (sgot)$4.97
84480Thyroid hormone$13.88
84479Thyroid hormone evaluation$6.34
84402Testosterone (hormone) level$24.87
84466Transferrin (iron binding protein) level$12.45
84425Vitamin b-1 (thiamine) level$20.70
84432Thyroglobulin (thyroid related hormone) level$15.72

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.