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CPT 82378: Carcinoembryonic Antigen (CEA) Quantitative Assay
CPT code 82378 denotes a quantitative laboratory assay for carcinoembryonic antigen (CEA), a tumor marker most commonly used to monitor patients with colon cancer and to follow other malignancies. As a widely ordered laboratory service, CEA testing plays a role in post-treatment surveillance and in assessing disease progression or recurrence, making accurate coding and coverage understanding important for clinical and billing workflows nationwide. Key payers in typical coverage analyses include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. This publication provides a concise national overview of CPT code 82378, presenting clinical context, common sites of service, and the coverage environment. Readers will find practical benchmarks for utilization and reimbursement patterns, summaries of payer policies that affect claim processing, and clinical notes on appropriate use and testing contexts. The content is intended to help billing managers, laboratory directors, and healthcare policy stakeholders understand where 82378 fits in laboratory service lines, typical clinical indications, and the payer landscape that influences claims and utilization at a national level. Data not available in the input for certain payer-specific policy details or associated diagnosis codes is noted where applicable.
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Billing Code Overview
CPT code 82378 describes a laboratory test that measures the quantity of carcinoembryonic antigen (CEA) in blood or other bodily fluids. The test is performed by a clinical laboratory technologist or analyst and is primarily used to monitor patients with colon cancer and to assist in monitoring other types of cancer.
Service type: Laboratory — Quantitative tumor marker assay
Typical site of service: Clinical laboratory or hospital outpatient laboratory, with specimens collected in physician offices, outpatient clinics, or inpatient settings as appropriate.
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.