CPT 84403: Total Testosterone, Serum
Commercial payers pay $56 on average nationally for this procedure.
CPT code 84403 describes a laboratory assay performed by a clinical lab analyst to measure total testosterone in patient serum; this is a diagnostic laboratory test typically provided in clinical laboratory or hospital outpatient settings for evaluation of androgen status and endocrine concerns.
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
Commercial reimbursement for CPT 84403 centers around a BUCA average of $56.20, with Blue Cross Blue Shield and Aetna showing higher mean levels and wider dispersion in paid amounts. Blue Cross Blue Shield’s interquartile range (P75–P25) is $38.50 ($97.70 − $58.20), indicating the widest midspread among payers; Aetna’s IQR is $14.0 ($33.90 − $19.0), representing a moderate spread. UnitedHealth Group and Cigna display tighter midspreads: UnitedHealth Group’s IQR is $14.40 ($25.80 − $11.40) and Cigna’s IQR is $25.80 ($36.90 − $14.10), placing Cigna between the narrow and wide extremes.
Median and mean contrasts point to skew in some contracts: Blue Cross Blue Shield’s mean of $78.70 exceeds its median of $68.40, suggesting higher outliers on the upper end, while UnitedHealth Group’s mean of $22.40 is closer to its median of $15.50, indicating a more symmetric distribution. Aetna and Cigna show means modestly above their medians, and BUCA as the average commercial benchmark sits near the middle of payer means at $56.20, serving as a useful market reference.