CPT 82378: Carcinoembryonic Antigen (CEA) Quantitative
Commercial payers pay $48 on average nationally for this procedure.
CPT code 82378 describes a laboratory test that quantitatively measures carcinoembryonic antigen (CEA) in blood or other bodily fluids, a tumor marker most commonly used to monitor patients with colorectal cancer and to follow treatment response or disease recurrence; service type is clinical laboratory testing and the typical site of service is an outpatient or hospital laboratory where the technical component of the assay is performed.
For related coverage guidance, see recent payer policy updates: Salivary Hormone Testing, Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing, Bone Turnover Markers Testing.
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National Reimbursement Benchmarks
For CPT 82378, BUCA’s average commercial rate of $48 sits near the middle of the payer mix, providing a useful benchmark for national commercial reimbursement. Blue Cross Blue Shield displays the highest central tendency with a median of $67.3 and substantial upside to a $194.6 maximum, while Cigna and Aetna both show mid-to-low average levels around $19.9 and $18.2 respectively; UnitedHealth Group’s mean of $16.6 and median of $11.4 skew its distribution lower relative to BUCA.
Assessing dispersion via the interquartile spread (P75 minus P25) highlights variability across payers: Blue Cross Blue Shield is relatively wide with a spread of $25.5, indicating greater variability, while UnitedHealth Group is tighter at $10.5. Aetna’s spread is $8, Cigna’s is $16.7, and BUCA’s interquartile spread is $16.2; these comparisons show Blue Cross Blue Shield as the most dispersed and Aetna as the tightest among the listed payers.