2018 Clinical Diagnostic Laboratory Fee Schedule …
[Pages:30]2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
HCPCS Modifier
SHORTDESC
36415
Routine venipuncture
78267
Breath tst attain/anal c-14
78268
Breath test analysis c-14
80047
Metabolic panel ionized ca
80047 QW Metabolic panel ionized ca
80048
Metabolic panel total ca
80048 QW Metabolic panel total ca
80050
General health panel
80051
Electrolyte panel
80051 QW Electrolyte panel
80053
Comprehen metabolic panel
80053 QW Comprehen metabolic panel
80055
Obstetric panel
80061
Lipid panel
80061 QW Lipid panel
80069
Renal function panel
80069 QW Renal function panel
80074
Acute hepatitis panel
80076
Hepatic function panel
80081
Obstetric panel
80150
Assay of amikacin
80155
Drug screen quant caffeine
80156
Assay carbamazepine total
80157
Assay carbamazepine free
80158
Assay of cyclosporine
80159
Drug screen quant clozapine
80162
Assay of digoxin
80163
Assay of digoxin free
80164
Assay dipropylacetic acid
80165
Dipropylacetic acid free
80168
Assay of ethosuximide
80169
Drug screen quant everolimus
80170
Assay of gentamicin
80171
Drug screen quant gabapentin
80173
Assay of haloperidol
80175
Drug screen quan lamotrigine
80176
Assay of lidocaine
80177
Drug scrn quan levetiracetam
80178
Assay of lithium
80178 QW Assay of lithium
80180
Drug scrn quan mycophenolate
80183
Drug scrn quant oxcarbazepin
80184
Assay of phenobarbital
80185
Assay of phenytoin total
80186
Assay of phenytoin free
80188
Assay of primidone
80190
Assay of procainamide
80192
Assay of procainamide
80194
Assay of quinidine
80195
Assay of sirolimus
80197
Assay of tacrolimus
80198
Assay of theophylline
Medicare 3.00 11.06 94.41 13.73 13.73 10.44 10.44 50.13 8.66 8.66 13.04 13.04 59.02 16.53 16.53 10.72 10.72 58.81 10.09 92.42 18.61 38.57 17.98 16.36 22.28 22.83 16.39 16.39 16.72 16.72 20.17 16.96 20.22 21.67 17.98 16.36 18.14 16.36 8.16 8.16 22.28 16.36 15.30 16.36 16.99 20.48 60.00 20.68 18.03 16.96 16.96 17.46
WV Medicaid 3.00 9.95 84.97 12.36 12.36 9.40 9.40 45.12 7.79 7.79 11.74 11.74 53.12 14.88 14.88 9.65 9.65 52.93 9.08 83.18 16.75 34.71 16.18 14.72 20.05 20.55 14.75 14.75 15.05 15.05 18.15 15.26 18.20 19.50 16.18 14.72 16.33 14.72 7.34 7.34 20.05 14.72 13.77 14.72 15.29 18.43 54.00 18.61 16.23 15.26 15.26 15.71
1
2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
HCPCS Modifier
SHORTDESC
Medicare
WV Medicaid
80199
Drug screen quant tiagabine
27.11
24.40
80200
Assay of tobramycin
19.91
17.92
80201
Assay of topiramate
14.72
13.25
80202
Assay of vancomycin
16.72
15.05
80203
Drug screen quant zonisamide
16.36
14.72
80299
Quantitative assay drug
18.64
16.78
80305
Drug test prsmv dir opt obs
13.46
12.11
80306
Drug test prsmv instrmnt
17.96
16.16
80307
Drug test prsmv chem anlyzr
71.83
64.65
80400
Acth stimulation panel
40.27
36.24
80402
Acth stimulation panel
107.35
96.62
80406
Acth stimulation panel
96.62
86.96
80408
Aldosterone suppression eval
154.94
139.45
80410
Calcitonin stimul panel
33.08
29.77
80412
CRH stimulation panel
801.62
721.46
80414
Testosterone response
63.75
57.38
80415
Estradiol response panel
68.99
62.09
80416
Renin stimulation panel
209.32
188.39
80417
Renin stimulation panel
54.31
48.88
80418
Pituitary evaluation panel
715.43
643.89
80420
Dexamethasone panel
161.88
145.69
80422
Glucagon tolerance panel
56.88
51.19
80424
Glucagon tolerance panel
62.34
56.11
80426
Gonadotropin hormone panel
183.22
164.90
80428
Growth hormone panel
82.35
74.12
80430
Growth hormone panel
129.33
116.40
80432
Insulin suppression panel
166.79
150.11
80434
Insulin tolerance panel
285.03
256.53
80435
Insulin tolerance panel
127.18
114.46
80436
Metyrapone panel
112.55
101.30
80438
TRH stimulation panel
62.24
56.02
80439
TRH stimulation panel
82.98
74.68
80500
Clinical pathology consultation; limited, with1o6u.t2r9eview of patien1t6's.2h9istory and medical records
80502
Clinical pathology consultation; comprehensi5v2e.,3f5or a complex d5ia2g.3n5ostic problem, with review of patient's history and medi
81000
Urinalysis nonauto w/scope
4.02
3.62
81001
Urinalysis auto w/scope
3.92
3.53
81002
Urinalysis nonauto w/o scope
3.48
3.13
81002
Urinalysis nonauto w/o scope
3.48
3.13
81003
Urinalysis auto w/o scope
2.77
2.49
81003 QW Urinalysis auto w/o scope
2.77
2.49
81005
Urinalysis
2.67
2.40
81007
Urine screen for bacteria
29.98
26.98
81007 QW Urine screen for bacteria
29.98
26.98
81015
Microscopic exam of urine
3.76
3.38
81020
Urinalysis glass test
4.70
4.23
81025
Urine pregnancy test
8.61
7.75
81050
Volume measurement for timed collection, eac3h.71
3.34
81099
Unlisted urinalysis procedure Manual/Unlisted Manual/Unlisted
81105
Hpa-1 genotyping
150.89
135.80
81106
Hpa-2 genotyping
150.89
135.80
81107
Hpa-3 genotyping
150.89
135.80
81108
Hpa-4 genotyping
150.89
135.80
2
2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
HCPCS Modifier
SHORTDESC
Medicare
WV Medicaid
81109
Hpa-5 genotyping
150.89
135.80
81110
Hpa-6 genotyping
150.89
135.80
81111
Hpa-9 genotyping
150.89
135.80
81112
Hpa-15 genotyping
150.89
135.80
81120
Idh1 common variants
193.25
173.93
81121
Idh2 common variants
295.79
266.21
81161
Dmd dup/delet analysis
279.00
251.10
81162
Brca1&2 seq & full dup/del
2,252.93
2,027.64
81170
Abl1 gene
300.00
270.00
81175
Asxl1 full gene sequence
707.02
636.32
81176
Asxl1 gene target seq alys
298.64
268.78
81200
ASPA (ASPARTOACYLASE) (EG, CANA4V7A.2N5 DISEASE) G4E2N.5E3 ANALYSIS, COMMON VARIANTS (EG, E285A, Y
81201
APC (adenomatous polyposis coli) (eg, fam7il8ia0l.0a0denomatosis p7o0l2y.p0o0sis [FAP], attenuated FAP) gene analysis; full gene seq
81202
APC (adenomatous polyposis coli) (eg, fam2il8ia0l.0a0denomatosis p2o5l2y.p0o0sis [FAP], attenuated FAP) gene analysis; known famil
81203
APC (adenomatous polyposis coli) (eg, fam2il0ia0l.0a0denomatosis p1o8l0y.p0o0sis [FAP], attenuated FAP) gene analysis; duplication/d
81205
BCKDHB (BRANCHED-CHAIN KETO AC9I4D.9D9 EHYDROGE8N5A.4S9E E1, BETA POLYPEPTIDE) (EG, MAPLE SYRUP
81206
Bcr/abl1 gene major bp
202.42
182.18
81207
Bcr/abl1 gene minor bp
178.81
160.93
81208
Bcr/abl1 gene other bp
214.62
193.16
81209
BLM (BLOOM SYNDROME, RECQ HELI3C9A.3S1E-LIKE) (EG,3B5L.3O8OM SYNDROME) GENE ANALYSIS, 2281DEL6IN
81210
Braf gene
175.40
157.86
81211
Brca1&2 seq & com dup/del
2,395.84
2,156.26
81212
Brca1&2 185&5385&6174 var
440.00
396.00
81213
Brca1&2 uncom dup/del var
553.00
497.70
81214
Brca1 full seq & com dup/del
1,301.42
1,171.28
81215
Brca1 gene known fam variant
375.25
337.73
81216
BRCA2 (BREAST CANCER 2) (EG, HER1E8D5I.1T2ARY BREAS1T66A.6N1D OVARIAN CANCER) GENE ANALYSIS; FULL S
81217
Brca2 gene known fam variant
375.25
337.73
81218
CEBPA (CCAAT/enhamcer binding protein29[C8./6E4BP], alpha) (e2g6,8a.7c8ute myeloid leukemia), gene analysis, full gene sequenc
81220
CFTR (CYSTIC FIBROSIS TRANSMEMB5R56A.6N0E CONDUCT50A0N.9C4E REGULATOR) (EG, CYSTIC FIBROSIS) GENE A
81221
CFTR (CYSTIC FIBROSIS TRANSMEMBR97A.2N2E CONDUCT8A7N.5C0E REGULATOR) (EG, CYSTIC FIBROSIS) GENE A
81222
CFTR (CYSTIC FIBROSIS TRANSMEMB4R35A.0N7E CONDUCT39A1N.5C6E REGULATOR) (EG, CYSTIC FIBROSIS) GENE A
81223
CFTR (CYSTIC FIBROSIS TRANSMEMB4R99A.0N0E CONDUCT44A9N.1C0E REGULATOR) (EG, CYSTIC FIBROSIS) GENE A
81235
Egfr gene com variants
324.58
292.12
81238
F9 full gene sequence
600.00
540.00
81240
F2 gene
65.69
59.12
81241
F5 gene
75.44
67.90
81242
FANCC (FANCONI ANEMIA, COMPLEM3E6N.6T2ATION GROU32P.9C6) (EG, FANCONI ANEMIA, TYPE C) GENE ANALY
81243
FMR1 (FRAGILE X MENTAL RETARDAT57IO.0N4 1) (EG, FRA5G1I.L3E4 X MENTAL RETARDATION) GENE ANALYSIS;
81244
FMR1 (FRAGILE X MENTAL RETARDAT44IO.8N9 1) (EG, FRA4G0I.L4E0 X MENTAL RETARDATION) GENE ANALYSIS;
81245
Flt3 gene
165.51
148.96
81246
Flt3 gene analysis
83.00
74.70
81247
G6pd gene alys cmn variant
174.81
157.33
81248
G6pd known familial variant
375.25
337.73
81249
G6pd full gene sequence
600.00
540.00
81252
GJB2 (gap junction protein, beta 2, 26kDa, 1c0o1n.n1e2xin 26) (eg, no9n1s.y0n1dromic hearing loss) gene analysis; full gene sequence
81253
GJB2 (gap junction protein, beta 2, 26kDa; c6o1n.n5e2xin 26) (eg, no5n5s.y3n7dromic hearing loss) gene analysis; known familial vari
81254
GJB6 (gap junction protein, beta 6, 30kDa, c3o5n.n0e0xin 30) (eg, no3n1s.y5n0dromic hearing loss) gene analysis, common variants (e
81255
HEXA (HEXOSAMINIDASE A [ALPHA P5O1L.4Y5PEPTIDE]) (E4G6.,3T1AY-SACHS DISEASE) GENE ANALYSIS, COMMO
81256
Hfe gene
80.69
72.62
81257
HBA1/HBA2 (ALPHA GLOBIN 1 AND A1L0P2H.2A6 GLOBIN 2) (9E2G.0,3ALPHA THALASSEMIA, HB BART HYDROPS FE
81258
Hba1/hba2 gene fam vrnt
375.25
337.73
3
2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
HCPCS Modifier
SHORTDESC
Medicare
WV Medicaid
81259
Hba1/hba2 full gene sequence
600.00
540.00
81261
Igh gene rearrange amp meth
244.43
219.99
81262
Igh gene rearrang dir probe
68.55
61.70
81263
Igh vari regional mutation
363.60
327.24
81264
Igk rearrangeabn clonal pop
184.35
165.92
81265
Str markers specimen anal
265.49
238.94
81266
Comparative analysis using Short Tandem R3e0p4e.8a1t (STR) marke2r7s4; .e3a3ch additional specimen (eg, additional cord blood dono
81267
Chimerism anal no cell selec
256.12
230.51
81268
Chimerism anal w/cell select
321.96
289.76
81269
Hba1/hba2 gene dup/del vrnts
202.40
182.16
81270
Jak2 gene
113.17
101.85
81272
Kit gene targeted seq analys
329.51
296.56
81275
Kras gene
193.25
173.93
81276
Kras gene addl variants
193.25
173.93
81280
Long QT Sydrome Gene Analysis(EG, KCN41Q61.,0K8 CNH2, SCN357A4,.4K7CNE1, KCNE2, KCNJ2, CACNA1C, CAV3, SCN4B,
81288
Mlh1 gene
192.32
173.09
81290
MCOLN1 (MUCOLIPIN 1) (EG, MUCOLIP3I9D.3O1SIS, TYPE IV3)5G.3E8NE ANALYSIS, COMMON VARIANTS (EG, IVS3-2
81291
Mthfr gene
65.34
58.81
81292
Mlh1 gene full seq
675.40
607.86
81293
Mlh1 gene known variants
331.00
297.90
81294
Mlh1 gene dup/delete variant
202.40
182.16
81295
Msh2 gene full seq
381.70
343.53
81296
Msh2 gene known variants
337.73
303.96
81297
Msh2 gene dup/delete variant
213.30
191.97
81298
Msh6 gene full seq
641.85
577.67
81299
Msh6 gene known variants
308.00
277.20
81300
Msh6 gene dup/delete variant
238.00
214.20
81301
Microsatellite instability
357.48
321.73
81310
Npm1 gene
246.52
221.87
81314
Pdgfra gene
329.51
296.56
81315
Pml/raralpha com breakpoints
255.94
230.35
81316
Pml/raralpha 1 breakpoint
255.94
230.35
81317
Pms2 gene full seq analysis
707.02
636.32
81318
Pms2 known familial variants
331.00
297.90
81319
Pms2 gene dup/delet variants
203.50
183.15
81321
Pten gene full sequence
600.00
540.00
81322
Pten gene known fam variant
52.85
47.57
81323
Pten gene dup/delet variant
300.00
270.00
81324
PMP22 (peripheral myelin protein 22) (eg, C75h8a.r3c6ot-Marie-Too6th8,2h.5e2reditary neuropathy with liability to pressure palsies) ge
81325
PMP22 (peripheral myelin protein 22) (eg, C76h9a.r5c8ot-Marie-Too6th9,2h.6e2reditary neuropathy with liability to pressure palsies) ge
81326
PMP22 (peripheral myelin protein 22) (eg, C5h2a.r8c5ot-Marie-Tooth4,7h.5e7reditary neuropathy with liability to pressure palsies) ge
81331
SNRPN/UBE3A (SMALL NUCLEAR RIBO5N1.U07CLEOPROTEI4N5.P96OLYPEPTIDE N AND UBIQUITIN PROTEIN LIGAS
81332
Serpina1 gene
53.89
48.50
81334
Runx1 gene targeted seq alys
329.51
296.56
81340
Trb@ gene rearrange amplify
257.92
232.13
81341
Trb@ gene rearrange dirprobe
61.22
55.10
81342
Trg gene rearrangement anal
248.76
223.88
81361
Hbb gene com variants
174.81
157.33
81362
Hbb gene known fam variant
375.25
337.73
81363
Hbb gene dup/del variants
202.40
182.16
81364
Hbb full gene sequence
324.58
292.12
81370
Hla i & ii typing lr
496.45
446.81
4
2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
HCPCS Modifier
SHORTDESC
Medicare
WV Medicaid
81371
Hla i & ii type verify lr
404.52
364.07
81372
Hla i typing complete lr
403.59
363.23
81373
Hla i typing 1 locus lr
137.48
123.73
81374
Hla i typing 1 antigen lr
89.81
80.83
81375
Hla ii typing ag equiv lr
272.52
245.27
81376
Hla ii typing 1 locus lr
150.89
135.80
81377
Hla ii type 1 ag equiv lr
113.35
102.02
81378
Hla i & ii typing hr
426.63
383.97
81379
Hla i typing complete hr
414.05
372.65
81380
Hla i typing 1 locus hr
218.83
196.95
81381
Hla i typing 1 allele hr
169.90
152.91
81382
Hla ii typing 1 loc hr
152.69
137.42
81383
Hla ii typing 1 allele hr
134.73
121.26
81410
Aortic dysfunction/dilation
504.00
453.60
81411
Aortic dysfunction/dilation
1,350.19
1,215.17
81412
Ashkenazi jewish assoc dis
2,448.56
2,203.70
81420
Fetal chrmoml aneuploidy
759.05
683.15
81432
Hrdtry brst ca-rlatd dsordrs
838.33
754.50
81433
Hrdtry brst ca-rlatd dsordrs
541.89
487.70
81434
Hereditary retinal disorders
597.91
538.12
81435
Hereditary colon cancer
722.10
649.89
81436
Hereditary colon ca synd
722.10
649.89
81437
Heredtry nurondcrn tum dsrdr
541.89
487.70
81438
Heredtry nurondcrn tum dsrdr
541.89
487.70
81442
Noonan spectrum disorders
2,143.60
1,929.24
81479
Unlisted molecular pathology proMceadnuureal/Unlisted Manual/Unlisted
81507
Fetal aneuploidy (trisomy 21, 18 and 13) DN79A5.s0e0quence analys7i1s5o.f50selected regions using maternal plasma, algorithm repor
81519
Oncology breast mrna
3,873.00
3,485.70
81539
Oncology prostate prob score
760.00
684.00
81595
Cardiology hrt trnspl mrna
3,240.00
2,916.00
81599
Unlisted multianalyte assay with aMlgaonruitahlm/UicnlaisntaeldysisManual/Unlisted
82009
Test for acetone/ketones
5.58
5.02
82010
Acetone assay
10.09
9.08
82010 QW Acetone assay
10.09
9.08
82013
Acetylcholinesterase assay
13.79
12.41
82016
Acylcarnitines qual
17.13
15.42
82017
Acylcarnitines quant
20.83
18.75
82024
Assay of acth
47.68
42.91
82030
Assay of adp & amp
31.85
28.67
82040
Assay of serum albumin
6.11
5.50
82040 QW Assay of serum albumin
6.11
5.50
82042
Assay of urine albumin
7.78
7.00
82043
Microalbumin quantitative
7.14
6.43
82043 QW Microalbumin quantitative
7.14
6.43
82044
Microalbumin semiquant
6.23
5.61
82044 QW Microalbumin semiquant
6.23
5.61
82045
Albumin ischemia modified
41.90
37.71
82075
Assay of breath ethanol
30.00
27.00
82085
Assay of aldolase
11.99
10.79
82088
Assay of aldosterone
50.31
45.28
82103
Alpha-1-antitrypsin total
16.59
14.93
82104
Alpha-1-antitrypsin pheno
17.86
16.07
5
2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
HCPCS Modifier
SHORTDESC
82105
Alpha-fetoprotein serum
82106
Alpha-fetoprotein amniotic
82107
Alpha-fetoprotein l3
82108
Assay of aluminum
82120
Amines vaginal fluid qual
82120 QW Amines vaginal fluid qual
82127
Amino acid single qual
82128
Amino acids mult qual
82131
Amino acids single quant
82135
Assay aminolevulinic acid
82136
Amino acids quant 2-5
82139
Amino acids quan 6 or more
82140
Ammonia
82143
Amniotic fluid scan
82150
Assay of amylase
82150 QW Assay of amylase
82154
Androstanediol glucuronide
82157
Assay of androstenedione
82160
Assay of androsterone
82163
Assay of angiotensin II
82164
Angiotensin I enzyme test
82172
Assay of apolipoprotein
82175
Assay of arsenic
82180
Assay of ascorbic acid
82190
Atomic absorption
82232
Assay of beta-2 protein
82239
Bile acids total
82240
Bile acids cholylglycine
82247
Bilirubin total
82247 QW Bilirubin total
82248
Bilirubin direct
82252
Fecal bilirubin test
82261
Assay of biotinidase
82270
Occult blood feces
82271
Occult blood other sources
82271 QW Occult blood other sources
82272
Occult bld feces 1-3 tests
82274
Assay test for blood fecal
82274 QW Assay test for blood fecal
82286
Assay of bradykinin
82300
Assay of cadmium
82306
Vitamin d 25 hydroxy
82308
Assay of calcitonin
82310
Assay of calcium
82310 QW Assay of calcium
82330
Assay of calcium
82330 QW Assay of calcium
82331
Calcium infusion test
82340
Assay of calcium in urine
82355
Calculus analysis qual
82360
Calculus assay quant
82365
Calculus spectroscopy
Medicare 20.71 20.71 79.52 31.46 5.99 5.99 17.13 17.13 22.98 20.31 20.83 20.83 17.99 9.35 8.00 8.00 35.60 36.14 30.87 25.34 18.03 21.09 23.42 12.20 18.41 19.97 21.14 32.81 6.19 6.19 6.19 5.63 20.83 4.38 5.32 5.32 4.23 19.64 19.64 6.37 28.58 36.55 33.08 6.37 6.37 16.88 16.88 13.34 7.44 14.29 15.89 15.92
WV Medicaid 18.64 18.64 71.57 28.31 5.39 5.39 15.42 15.42 20.68 18.28 18.75 18.75 16.19 8.42 7.20 7.20 32.04 32.53 27.78 22.81 16.23 18.98 21.08 10.98 16.57 17.97 19.03 29.53 5.57 5.57 5.57 5.07 18.75 3.94 4.79 4.79 3.81 17.68 17.68 5.73 25.72 32.90 29.77 5.73 5.73 15.19 15.19 12.01 6.70 12.86 14.30 14.33
6
2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
HCPCS Modifier
SHORTDESC
82370
X-ray assay calculus
82373
Assay c-d transfer measure
82374
Assay blood carbon dioxide
82374 QW Assay blood carbon dioxide
82375
Assay carboxyhb quant
82376
Assay carboxyhb qual
82378
Carcinoembryonic antigen
82379
Assay of carnitine
82380
Assay of carotene
82382
Assay urine catecholamines
82383
Assay blood catecholamines
82384
Assay three catecholamines
82387
Assay of cathepsin-d
82390
Assay of ceruloplasmin
82397
Chemiluminescent assay
82415
Assay of chloramphenicol
82435
Assay of blood chloride
82435 QW Assay of blood chloride
82436
Assay of urine chloride
82438
Assay other fluid chlorides
82441
Test for chlorohydrocarbons
82465
Assay bld/serum cholesterol
82465 QW Assay bld/serum cholesterol
82480
Assay serum cholinesterase
82482
Assay rbc cholinesterase
82485
Assay chondroitin sulfate
82495
Assay of chromium
82507
Assay of citrate
82523
Collagen crosslinks
82523 QW Collagen crosslinks
82525
Assay of copper
82528
Assay of corticosterone
82530
Cortisol free
82533
Total cortisol
82540
Assay of creatine
82542
Column chromotography quant
82550
Assay of ck (cpk)
82550 QW Assay of ck (cpk)
82552
Assay of cpk in blood
82553
Creatine mb fraction
82554
Creatine isoforms
82565
Assay of creatinine
82565 QW Assay of creatinine
82570
Assay of urine creatinine
82570 QW Assay of urine creatinine
82575
Creatinine clearance test
82585
Assay of cryofibrinogen
82595
Assay of cryoglobulin
82600
Assay of cyanide
82607
Vitamin B-12
82608
B-12 binding capacity
82610
Cystatin c
Medicare 15.46 22.29 6.03 6.03 15.21 14.07 23.41 20.83 11.39 27.30 30.93 31.18 22.29 13.26 17.43 15.64 5.68 5.68 6.21 6.03 7.42 5.37 5.37 9.72 9.81 25.50 25.04 34.33 23.07 23.07 15.32 27.80 20.63 20.12 5.72 24.09 8.04 8.04 16.53 14.26 14.65 6.33 6.33 6.39 6.39 11.67 14.14 7.98 23.95 18.61 17.68 18.52
WV Medicaid 13.91 20.06 5.43 5.43 13.69 12.66 21.07 18.75 10.25 24.57 27.84 28.06 20.06 11.93 15.69 14.08 5.11 5.11 5.59 5.43 6.68 4.83 4.83 8.75 8.83 22.95 22.54 30.90 20.76 20.76 13.79 25.02 18.57 18.11 5.15 21.68 7.24 7.24 14.88 12.83 13.19 5.70 5.70 5.75 5.75 10.50 12.73 7.18 21.56 16.75 15.91 16.67
7
2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
HCPCS Modifier
SHORTDESC
82615
Test for urine cystines
82626
Dehydroepiandrosterone
82627
Dehydroepiandrosterone
82633
Desoxycorticosterone
82634
Deoxycortisol
82638
Assay of dibucaine number
82652
Vit d 1 25-dihydroxy
82656
Pancreatic elastase fecal
82657
Enzyme cell activity
82658
Enzyme cell activity ra
82664
Electrophoretic test
82668
Assay of erythropoietin
82670
Assay of estradiol
82671
Assay of estrogens
82672
Assay of estrogen
82677
Assay of estriol
82679
Assay of estrone
82679 QW Assay of estrone
82693
Assay of ethylene glycol
82696
Assay of etiocholanolone
82705
Fats/lipids feces qual
82710
Fats/lipids feces quant
82715
Assay of fecal fat
82725
Assay of blood fatty acids
82726
Long chain fatty acids
82728
Assay of ferritin
82731
Assay of fetal fibronectin
82735
Assay of fluoride
82746
Assay of folic acid serum
82747
Assay of folic acid rbc
82757
Assay of semen fructose
82759
Assay of rbc galactokinase
82760
Assay of galactose
82775
Assay galactose transferase
82776
Galactose transferase test
82784
Assay iga/igd/igg/igm each
82785
Assay of ige
82787
Igg 1 2 3 or 4 each
82800
Blood pH
82803
Blood gases any combination
82805
Blood gases w/o2 saturation
82810
Blood gases o2 sat only
82820
Hemoglobin-oxygen affinity
82930
Gastric analy w/ph ea spec
82938
Gastrin test
82941
Assay of gastrin
82943
Assay of glucagon
82945
Glucose other fluid
82946
Glucagon tolerance test
82947
Assay glucose blood quant
82947 QW Assay glucose blood quant
82948
Reagent strip/blood glucose
Medicare 10.08 31.20 27.45 38.25 36.14 15.12 47.53 14.24 22.29 44.03 61.50 23.20 34.49 39.88 26.78 29.85 30.81 30.81 18.40 29.12 6.29 20.75 22.97 18.77 22.29 16.83 79.52 22.89 18.15 21.38 21.40 26.52 13.82 26.01 11.74 11.48 20.32 9.90 11.00 26.07 78.77 10.77 13.34 6.72 21.84 21.77 17.64 4.85 18.61 4.85 4.85 5.04
WV Medicaid 9.07 28.08 24.71 34.43 32.53 13.61 42.78 12.82 20.06 39.63 55.35 20.88 31.04 35.89 24.10 26.87 27.73 27.73 16.56 26.21 5.66 18.68 20.67 16.89 20.06 15.15 71.57 20.60 16.34 19.24 19.26 23.87 12.44 23.41 10.57 10.33 18.29 8.91 9.90 23.46 70.89 9.69 12.01 6.05 19.66 19.59 15.88 4.37 16.75 4.37 4.37 4.54
8
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