Find policies, billing codes, payers, states, and providers
CPT 84403: Total Testosterone Measurement in Serum
CPT code 84403 represents a laboratory test for total testosterone measured in patient serum. Nationally, this assay is a routine diagnostic tool for evaluating androgen status, endocrine disorders, and abnormal findings in blood chemistry. It has clinical relevance across endocrinology, urology, primary care, and men’s health populations, and is commonly ordered in both outpatient and hospital laboratory settings.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The report summarizes coverage patterns, reimbursement benchmarks, clinical context, and common laboratory groupings in which 84403 appears. Readers will find concise information on how this test relates to related laboratory services (such as free testosterone and prostate-specific antigen), typical clinical indications, and where it is commonly performed. The summary also highlights coding relationships that affect billing and bundling with other common panels and standalone assays.
This publication is intended for coding professionals, laboratory managers, clinicians involved in ordering hormone testing, and revenue cycle staff seeking a national-level overview of the clinical and billing context for CPT code 84403.
Customize your policy alerts
Sign up for cpt 84403 policy alerts
Get alerted when payer policies referencing 84403 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 84403 describes a laboratory assay in which a clinical laboratory analyst measures total testosterone concentration, typically performed on patient serum. This is a clinical laboratory service used to evaluate androgen status in patients.
-
Service type: Laboratory testing — hormone quantification
-
Typical site of service: Clinical laboratory or hospital laboratory; specimen collected in an outpatient clinic or hospital outpatient setting
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.