Measurement of serum iron level, typically ordered with iron binding capacity and ferritin to sort out the cause of anemia.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Hemoglobin or CBC result showing anemia, or the reason iron deficiency is suspected
- Diagnosis code for anemia or the underlying condition, with the pre-op encounter code secondary
- Signed order listing each iron study requested
- Planned procedure and date if ordered for surgical optimization
- ABN if the indication may fall outside the Medicare NCD
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
Serum iron, coded 83540, belongs to the preoperative anemia workup in an orthopedic practice. Joint replacement and spine programs that run patient blood management screen hemoglobin weeks before surgery, then order iron studies when the patient is anemic so iron deficiency can be treated before the case.
Iron is almost always ordered with total iron binding capacity (83550) and ferritin. Bill each test that was actually run. Medicare covers serum iron studies under a national coverage determination that lists covered diagnoses, so the diagnosis on the order has to be anemia, a condition causing blood loss, or another listed indication. "Pre-op clearance" on its own is a screening reason and gets denied.
Most ortho offices send this out. If your practice does run it, you need the right CLIA certificate for the test's complexity.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
Common denial reasons
The recurring reasons claims for CPT 83540 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Only a preoperative examination diagnosis linked
- Diagnosis not on the serum iron studies NCD covered list
- Frequency exceeds what the NCD allows without new findings
- Billed by the office when a reference lab ran it
- Missing ABN for a non-covered indication
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Does Medicare cover iron studies before joint replacement?
02Can I bill 83540 and 83550 together?
03Is ferritin included in 83540?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes the low hemoglobin and the plan to optimize before surgery, so the anemia diagnosis supports the iron studies on the claim.
See how Mira captures CPT 83540 documentation