Glucose, Blood (CPT 82947)
Medicare Rate vs. Lab Charges
Medicare pays $4.52 for this test. Labs commonly charge $20.00–$75.00. That's a 343%–1560% markup above what Medicare pays.
What This Test Is
Blood glucose (blood sugar) measures glucose concentration. It's one of the most basic tests, used to screen for and monitor diabetes. A fasting glucose is most accurate; random glucose can also be tested.
Medicare Rate vs. Lab Charges
| Medicare Allowable Rate | $4.52 |
| Typical Lab Charge Range | $20.00–$75.00 |
| Average Markup Above Medicare | 343%–1560% |
Does Medicare Cover This Test?
Yes, Medicare Part B covers blood glucose testing. Screening in asymptomatic patients is often covered as part of routine physicals; monitoring is covered for diabetic patients.
Common Reasons for Denial
- Ordered too frequently (e.g., daily at lab for non-diabetic patient)
- No clear indication for testing
- Home glucose monitoring should be used instead for diabetic patients
- Screening in very low-risk asymptomatic patient without justification
- Duplicate test same day
What To Do If You're Overcharged
If you received a lab bill that seems unusually high compared to Medicare rates:
- Check your Explanation of Benefits (EOB) from Medicare or your insurance to see what should have been paid.
- Request an itemized bill from the lab showing all charges.
- Compare to GougeStop rates for your area to see if the charge is reasonable.
- Contact the lab's billing department to dispute erroneous charges or negotiate a lower rate.
- File an appeal with Medicare if a claim was incorrectly denied.
Frequently Asked Questions
A: If your doctor ordered a fasting glucose, yes—8-12 hours without food. Random glucose doesn't require fasting. Ask your lab which type was ordered.
A: Annual screening is typical. If prediabetic or diabetic, your doctor may order fasting glucose 1-2 times per year, plus HbA1c every 3-6 months.
A: The Medicare rate is very low ($4.52), but lab overhead is fixed. For self-pay patients, labs charge more, leading to huge percentage markups despite low absolute cost.