CPT Code 84403Complete Billing & Coding Guide (2026)Assay of total testosterone
About CPT 84403
CPT 84403 is a Current Procedural Terminology code in the Pathology/Lab category maintained by the American Medical Association. The CMS short descriptor reads "Assay of total testosterone". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
Documentation specificity, correct ICD-10 linkage, and modifier accuracy determine whether 84403 pays cleanly or triggers a denial. Verify CMS National Physician Fee Schedule status, applicable Medicare LCDs, and any payer-specific medical policies before submission.
84403 has 5 NCCI bundling edit pairs documented. Run your scrubber against the NCCI quarterly update before submission. When clinically warranted, use modifier 59 or the X-modifiers (XE, XS, XP, XU) to bypass an indicator-1 edit, with chart documentation supporting the distinct service.
Code Properties
RVU Breakdown
Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.
Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.
NCCI Bundling Edits
5 pairsThese codes trigger National Correct Coding Initiative edits when billed with 84403. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.
Billing 84403 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.
Standards of medical/surgical practice
Standards of medical/surgical practice
Standards of medical/surgical practice
Standards of medical/surgical practice
CPT Manual or CMS manual coding instruction
Bundling denials on 84403 are recoverable when the edit indicator is 1 and the chart documents a distinct, separately identifiable service. Our coders verify the indicator and pick the precise X-modifier (XE, XS, XP, XU) instead of defaulting to modifier 59.
Applicable Modifiers
Modifiers commonly paired with 84403 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.
Component split modifiers (26 professional, TC technical) are the most under-applied modifiers in diagnostic billing. Practices that bill global on services where they only provided the read silently invite refund requests. We split components correctly at submission.
Supporting ICD-10 Diagnoses
These diagnosis codes commonly support medical necessity for CPT 84403. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.
CARC 50 medical-necessity denials carry both rework cost and an audit-risk signal when patterns repeat. Our coders verify ICD-10 specificity and policy alignment at the coding stage so these losses get prevented upstream.
Find the revenue leakage in your 84403 claims.
Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Pathology/Lab claims. Our AAPC-certified team audits your last 90 days of 84403 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.
Losing revenue on CPT 84403? We’ll find it.
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Related CPT Codes
Codes in the same family as 84403
Everything about CPT 84403
What does CPT code 84403 cover?
CPT 84403 is a Current Procedural Terminology code in the Pathology/Lab category maintained by the American Medical Association. The CMS short descriptor reads "Assay of total testosterone". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
What is the Medicare payment for CPT 84403?
The national average Medicare payment for CPT 84403 is approximately $0 in a non-facility setting and $0 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 0 with a conversion factor of $33.4009.
What is the global period for CPT 84403?
CPT 84403 has no global period (indicator XXX). There are no post-operative day restrictions tied to this code. Refer to CMS National Physician Fee Schedule rules and any applicable NCCI edits when billing on the same date as other services.
What codes bundle with CPT 84403?
CPT 84403 has NCCI Procedure-to-Procedure edits with 5+ codes including 80503, 80504, 80505. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.
CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.
Free 90-Day AR Recovery Audit
We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.