Summary & Overview
CPT 83874: Myoglobin Assay, Clinical Laboratory Measurement
CPT code 83874 represents a clinical laboratory assay measuring myoglobin levels in a patient specimen. Myoglobin testing is clinically relevant for detecting muscle injury, including myocardial damage and skeletal muscle breakdown, and can influence urgent diagnostic and treatment decisions. Nationally, myoglobin assays remain part of the laboratory toolkit for acute care and inpatient settings, informing triage and clinical interpretation alongside other biomarkers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes reimbursement benchmarks, coding guidance, and common billing considerations that affect laboratory services for myoglobin testing.
Readers will learn the clinical context for ordering a myoglobin assay, typical sites of service where CPT code 83874 is reported, and the payer mix relevant to U.S. coverage. The report also outlines common modifiers associated with laboratory billing when available and highlights where data was not provided. This national overview is intended to clarify the purpose of CPT code 83874, how it fits into acute diagnostic workflows, and the payer landscape that commonly reimburses this laboratory service.
Billing Code Overview
CPT code 83874 describes a laboratory measurement of myoglobin concentration in a patient specimen. The procedure involves a laboratory analyst quantifying the amount of myoglobin, a muscle protein released into blood or urine when muscle tissue is damaged.
Service type: Clinical laboratory test (myoglobin assay)
Typical site of service: Clinical laboratory or hospital laboratory
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to the emergency department or outpatient clinic with acute chest pain, shortness of breath, or recent severe muscle injury. The clinician orders a myoglobin test to assist in early detection of muscle injury or myocardial injury when troponin assays are pending or to evaluate suspected rhabdomyolysis. A blood specimen is collected by phlebotomy, labeled, and sent to the hospital or reference laboratory. A laboratory technologist or clinical chemist performs the 83874 myoglobin quantitative assay using immunoassay or automated chemistry analyzers. Results are reported in ng/mL and reviewed by the ordering provider; rapid turnaround is often prioritized in emergency settings. Typical sites of service include hospital inpatient laboratories, hospital outpatient laboratories, emergency departments, urgent care centers, and independent clinical laboratories.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the professional component of testing if the laboratory reportable interpretation or physician professional work is billed separately. |
90 |