How much does Medicare pay for CPT 84597?

Medicare allowed an average of $13.43 per service and paid $13.43 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $258.54, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 84597?

Vitamin k level. It was billed 9,898 times to 8,823 Medicare beneficiaries by 76 providers in 2024.

Which specialty bills 84597 most?

Clinical Laboratory, with 9,898 services from 76 clinicians.

CPT 84597

Vitamin k level

$13.43Medicare-allowed amount per service, averaged across 9,898 services

Providers submitted

$258.54

Asking price, not received

Medicare allowed

$13.43

The fee schedule figure

Medicare paid

$13.43

Balance is patient coinsurance

Providers submitted an average of $258.54 for this code and Medicare allowed $13.43 — 19.3× 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 $13.43 (100%); the rest is the patient’s coinsurance and deductible.

Services: 9,898
Beneficiaries: 8,823
Providers billing it: 76
Total allowed: $132,930

What Medicare pays for CPT 84597

Across 9,898 services billed by 76 providers to 8,823 beneficiaries, Medicare allowed an average of $13.43 per service. 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 84597

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	9,898	8,823	$13.43	76

84597 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	1,674	$13.44	$13.45	2
California	1,410	$13.45	$13.45	7
New York	1,194	$13.44	$13.45	4
New Jersey	1,068	$13.44	$13.45	6
Florida	938	$13.45	$13.45	4
Texas	627	$13.45	$13.45	7
Kansas	449	$13.45	$13.45	3
Arizona	421	$13.28	$13.45	3
Georgia	357	$13.45	$13.45	1
Washington	215	$13.45	$13.45	3
Ohio	204	$13.39	$13.45	4
Illinois	138	$13.45	$13.45	1
Massachusetts	137	$13.45	$13.45	2
Alabama	134	$13.45	$13.45	1
Oklahoma	125	$13.45	$13.45	3
Tennessee	122	$13.18	$13.45	3
Utah	116	$13.33	$13.45	2
Pennsylvania	92	$13.45	$13.45	3
Minnesota	89	$13.33	$13.45	2
Virginia	77	$13.45	$13.45	3
Colorado	69	$13.45	$13.45	2
Maryland	59	$13.45	$13.45	1
Nevada	41	$13.45	$13.45	1
Puerto Rico	36	$13.45	$13.45	2
Wisconsin	31	$13.45	$13.45	1
Hawaii	25	$13.45	$13.45	2
Oregon	23	$13.45	$13.45	1
Indiana	16	$13.45	$13.45	1
Connecticut	11	$13.45	$13.45	1

Related codes

84550Uric acid level$4.42
84520Urea nitrogen level to assess kidney function$3.85
84560Uric acid level$4.98
84540Urea nitrogen level to assess kidney function$5.44
84590Vitamin a level$11.34
84580Urobilinogen (metabolism substance) level$9.33
84585Urine vanillylmandelic acid$15.19
84591Vitamin measurement$16.71
84586Vasoactive intestinal peptide (intestinal hormone) level$34.58
84588Adh (antidiuretic hormone) level$33.24

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.