CPT® Code Lookup Tool

LIST OF CPT/HCPCS CODES USED TO DEFINE DESIGNATED HEALTH SERVICE CATEGORY: Clinical Laboratory Services

This code list is effective August 1, 2023

HCPCS/CPTDescriptionNational Avg. Reimbursement
36415Routine venipuncture $ 8.57
80047Metabolic panel ionized ca $ 13.73
80048Metabolic panel total ca $ 8.46
80051Electrolyte panel $ 7.01
80053Comprehen metabolic panel $ 10.56
80061Lipid panel $ 13.39
80069Renal function panel $ 8.68
80074Acute hepatitis panel $ 47.63
80076Hepatic function panel $ 8.17
80150Assay of amikacin $ 15.08
80155Drug assay caffeine $ 38.57
80156Assay carbamazepine total $ 14.57
80157Assay carbamazepine free $ 13.25
80158Drug assay cyclosporine $ 18.05
80159Drug assay clozapine $ 20.15
80162Assay of digoxin total $ 13.28
80163Assay of digoxin free $ 13.28
80164Assay dipropylacetic acd tot $ 13.54
80165Dipropylacetic acid free $ 13.54
80168Assay of ethosuximide $ 16.34
80169Drug assay everolimus $ 13.73
80170Assay of gentamicin $ 16.38
80171Drug screen quant gabapentin $ 21.67
80173Assay of haloperidol $ 15.78
80175Drug screen quan lamotrigine $ 13.25
80176Assay of lidocaine $ 14.69
80177Drug scrn quan levetiracetam $ 13.25
80178Assay of lithium $ 6.61
80180Drug scrn quan mycophenolate $ 18.05
80183Drug scrn quant oxcarbazepin $ 13.25
80184Assay of phenobarbital $ 15.30
80185Assay of phenytoin total $ 13.25
80186Assay of phenytoin free $ 13.76
80188Assay of primidone $ 16.59
80190Assay of procainamide $ 60.00
80192Assay of procainamide $ 16.75
80194Assay of quinidine $ 14.60
80195Assay of sirolimus $ 13.73
80197Assay of tacrolimus $ 13.73
80198Assay of theophylline $ 14.14
80199Drug screen quant tiagabine $ 27.11
80200Assay of tobramycin $ 16.13
80201Assay of topiramate $ 11.92
80202Assay of vancomycin $ 13.54
80203Drug screen quant zonisamide $ 13.25
80299Quantitative assay drug $ 18.64
80400Acth stimulation panel $ 32.62
80402Acth stimulation panel $ 86.96
80406Acth stimulation panel $ 78.26
80408Aldosterone suppression eval $ 125.50
80410Calcitonin stimul panel $ 80.37
80412Crh stimulation panel $ 801.62
80414Testosterone response panel $ 51.64
80415Tot estradiol response panel $ 55.89
80416Renin stimulation panel $ 209.32
80417Renin stimulation panel $ 43.99
80418Pituitary evaluation panel $ 579.48
80420Dexamethasone panel $ 161.88
80422Glucagon tolerance panel $ 46.07
80424Glucagon tolerance panel $ 50.50
80426Gonadotropin hormone panel $ 148.41
80428Growth hormone panel $ 66.70
80430Growth hormone panel $ 129.33
80432Insulin suppression panel $ 165.61
80434Insulin tolerance panel $ 285.03
80435Insulin tolerance panel $ 103.00
80436Metyrapone panel $ 91.16
80438Trh stimulation panel $ 50.41
80439Trh stimulation panel $ 67.21
81000Urinalysis nonauto w/scope $ 4.02
81001Urinalysis auto w/scope $ 3.17
81002Urinalysis nonauto w/o scope $ 3.48
81003Urinalysis auto w/o scope $ 2.25
81005Urinalysis $ 2.17
81007Urine screen for bacteria $ 29.98
81015Microscopic exam of urine $ 3.05
81020Urinalysis glass test $ 4.70
81025Urine pregnancy test $ 8.61
81050Urinalysis volume measure $ 3.64
81161Dmd dup/delet analysis $ 279.00
81206Bcr/abl1 gene major bp $ 163.96
81207Bcr/abl1 gene minor bp $ 144.84
81208Bcr/abl1 gene other bp $ 214.62
81210Braf gene $ 175.40
81212Brca1&2 185&5385&6174 vrnt $ 440.00
81215Brca1 gene known famil vrnt $ 375.25
81217Brca2 gene known famil vrnt $ 375.25
81225Cyp2c19 gene com variants $ 291.36
81226Cyp2d6 gene com variants $ 450.91
81227Cyp2c9 gene com variants $ 174.81
81235Egfr gene com variants $ 324.58
81240F2 gene $ 65.69
81241F5 gene $ 73.37
81245Flt3 gene $ 165.51
81246Flt3 gene analysis $ 83.00
81256Hfe gene $ 65.36
81261Igh gene rearrange amp meth $ 197.99
81262Igh gene rearrang dir probe $ 68.55
81263Igh vari regional mutation $ 294.52
81264Igk rearrangeabn clonal pop $ 172.73
81265Str markers specimen anal $ 233.07
81267Chimerism anal no cell selec $ 207.46
81268Chimerism anal w/cell select $ 260.79
81270Jak2 gene $ 91.66
81275Kras gene variants exon 2 $ 193.25
81287Mgmt gene prmtr mthyltn alys $ 124.64
81288Mlh1 gene $ 192.32
81291Mthfr gene $ 65.34
81292Mlh1 gene full seq $ 675.40
81293Mlh1 gene known variants $ 331.00
81294Mlh1 gene dup/delete variant $ 202.40
81295Msh2 gene full seq $ 381.70
81296Msh2 gene known variants $ 337.73
81297Msh2 gene dup/delete variant $ 213.30
81298Msh6 gene full seq $ 641.85
81299Msh6 gene known variants $ 308.00
81300Msh6 gene dup/delete variant $ 238.00
81301Microsatellite instability $ 348.56
81310Npm1 gene $ 246.52
81313Pca3/klk3 antigen $ 255.05
81315Pml/raralpha com breakpoints $ 207.31
81316Pml/raralpha 1 breakpoint $ 207.31
81317Pms2 gene full seq analysis $ 676.50
81318Pms2 known familial variants $ 331.00
81319Pms2 gene dup/delet variants $ 203.50
81321Pten gene full sequence $ 600.00
81322Pten gene known fam variant $ 46.60
81323Pten gene dup/delet variant $ 300.00
81332Serpina1 gene $ 43.65
81340Trb@ gene rearrange amplify $ 208.92
81341Trb@ gene rearrange dirprobe $ 49.59
81342Trg gene rearrangement anal $ 201.50
81370Hla i & ii typing lr $ 402.12
81371Hla i & ii type verify lr $ 404.52
81372Hla i typing complete lr $ 403.59
81373Hla i typing 1 locus lr $ 127.43
81374Hla i typing 1 antigen lr $ 74.33
81375Hla ii typing ag equiv lr $ 220.74
81376Hla ii typing 1 locus lr $ 122.22
81377Hla ii type 1 ag equiv lr $ 94.74
81378Hla i & ii typing hr $ 345.57
81379Hla i typing complete hr $ 335.38
81380Hla i typing 1 locus hr $ 177.25
81381Hla i typing 1 allele hr $ 169.90
81382Hla ii typing 1 loc hr $ 123.68
81383Hla ii typing 1 allele hr $ 109.13
81410Aortic dysfunction/dilation $ 504.00
81411Aortic dysfunction/dilation $ 1,350.19
81415Exome sequence analysis $ 4,780.00
81416Exome sequence analysis $ 12,000.00
81417Exome re-evaluation $ 320.00
81420Fetal chrmoml aneuploidy $ 759.05
81425Genome sequence analysis $ 5,031.20
81426Genome sequence analysis $ 2,709.95
81427Genome re-evaluation $ 2,337.65
81430Hearing loss sequence analys $ 1,625.00
81431Hearing loss dup/del analys $ 679.57
81435Hereditary colon ca dsordrs $ 584.90
81436Hereditary colon ca dsordrs $ 584.90
81440Mitochondrial gene $ 3,324.00
81445Tgsap so neo 5-50dna/dna&rna $ 597.91
81450Tgsap hl neo 5-50dna/dna&rna $ 759.53
81455Tgsap so/hl 51/> dna/dna&rna $ 2,919.60
81460Whole mitochondrial genome $ 1,287.00
81465Whole mitochondrial genome $ 936.00
81470X-linked intellectual dblt $ 914.00
81471X-linked intellectual dblt $ 914.00
81528Oncology colorectal scr $ 508.87
82009Test for acetone/ketones $ 4.52
82010Acetone assay $ 8.17
82013Acetylcholinesterase assay $ 12.29
82016Acylcarnitines qual $ 16.49
82017Acylcarnitines quant $ 16.87
82024Assay of acth $ 38.62
82030Assay of adp & amp $ 25.80
82040Assay of serum albumin $ 4.95
82042Other source albumin quan ea $ 7.78
82043Ur albumin quantitative $ 5.78
82044Ur albumin semiquantitative $ 6.23
82045Albumin ischemia modified $ 33.94
82075Assay of breath ethanol $ 30.00
82085Assay of aldolase $ 9.71
82088Assay of aldosterone $ 40.75
82103Alpha-1-antitrypsin total $ 13.44
82104Alpha-1-antitrypsin pheno $ 14.46
82105Alpha-fetoprotein serum $ 16.77
82106Alpha-fetoprotein amniotic $ 17.00
82107Alpha-fetoprotein l3 $ 64.41
82108Assay of aluminum $ 25.48
82120Amines vaginal fluid qual $ 5.99
82127Amino acid single qual $ 14.18
82128Amino acids mult qual $ 13.87
82131Amino acids single quant $ 22.98
82135Assay aminolevulinic acid $ 16.45
82136Amino acids quant 2-5 $ 19.61
82139Amino acids quan 6 or more $ 16.87
82140Assay of ammonia $ 14.57
82143Amniotic fluid scan $ 9.35
82150Assay of amylase $ 6.48
82154Androstanediol glucuronide $ 28.83
82157Assay of androstenedione $ 29.28
82160Assay of androsterone $ 25.55
82163Assay of angiotensin ii $ 20.52
82164Angiotensin i enzyme test $ 14.60
82172Assay of apolipoprotein $ 21.09
82175Assay of arsenic $ 18.97
82180Assay of ascorbic acid $ 9.89
82190Atomic absorption $ 15.90
82232Assay of beta-2 protein $ 16.18
82239Bile acids total $ 17.12
82240Bile acids cholylglycine $ 26.58
82247Bilirubin total $ 5.02
82248Bilirubin direct $ 5.02
82252Fecal bilirubin test $ 4.56
82261Assay of biotinidase $ 16.87
82270Occult blood feces $ 4.38
82271Occult blood other sources $ 5.32
82272Occult bld feces 1-3 tests $ 4.23
82274Assay test for blood fecal $ 15.92
82286Assay of bradykinin $ 5.16
82300Assay of cadmium $ 23.64
82306Vitamin d 25 hydroxy $ 29.60
82308Assay of calcitonin $ 26.79
82310Assay of calcium $ 5.16
82330Assay of calcium $ 13.68
82331Calcium infusion test $ 13.34
82340Assay of calcium in urine $ 6.03
82355Calculus analysis qual $ 11.58
82360Calculus assay quant $ 12.87
82365Calculus spectroscopy $ 12.90
82370X-ray assay calculus $ 12.52
82373Assay c-d transfer measure $ 18.06
82374Assay blood carbon dioxide $ 4.88
82375Assay carboxyhb quant $ 12.32
82376Assay carboxyhb qual $ 14.07
82378Carcinoembryonic antigen $ 18.96
82379Assay of carnitine $ 16.87
82380Assay of carotene $ 9.22
82382Assay urine catecholamines $ 27.30
82383Assay blood catecholamines $ 29.08
82384Assay three catecholamines $ 25.25
82387Assay of cathepsin-d $ 18.06
82390Assay of ceruloplasmin $ 10.74
82397Chemiluminescent assay $ 14.12
82415Assay of chloramphenicol $ 12.67
82435Assay of blood chloride $ 4.60
82436Assay of urine chloride $ 5.75
82438Assay other fluid chlorides $ 5.00
82441Test for chlorohydrocarbons $ 6.01
82465Assay bld/serum cholesterol $ 4.35
82480Assay serum cholinesterase $ 7.87
82482Assay rbc cholinesterase $ 9.81
82485Assay chondroitin sulfate $ 20.65
82495Assay of chromium $ 20.28
82507Assay of citrate $ 27.80
82523Collagen crosslinks $ 18.68
82525Assay of copper $ 12.41
82528Assay of corticosterone $ 22.52
82530Cortisol free $ 16.71
82533Total cortisol $ 16.30
82540Assay of creatine $ 4.64
82542Col chromotography qual/quan $ 24.09
82550Assay of ck (cpk) $ 6.51
82552Assay of cpk in blood $ 13.39
82553Creatine mb fraction $ 11.55
82554Creatine isoforms $ 11.87
82565Assay of creatinine $ 5.12
82570Assay of urine creatinine $ 5.18
82575Creatinine clearance test $ 9.46
82585Assay of cryofibrinogen $ 14.14
82595Assay of cryoglobulin $ 6.47
82600Assay of cyanide $ 19.40
82607Vitamin b-12 $ 15.08
82608B-12 binding capacity $ 14.32
82610Cystatin c $ 18.52
82615Test for urine cystines $ 9.55
82626Dehydroepiandrosterone $ 25.27
82627Dehydroepiandrosterone $ 22.23
82633Desoxycorticosterone $ 30.98
82634Deoxycortisol $ 29.28
82638Assay of dibucaine number $ 12.25
82652Vit d 1 25-dihydroxy $ 38.50
82656El-1 fecal qual/semiq $ 11.53
82657Enzyme cell activity $ 22.17
82658Enzyme cell activity ra $ 44.03
82664Electrophoretic test $ 61.50
82668Assay of erythropoietin $ 18.79
82670Assay of total estradiol $ 27.94
82671Assay of estrogens $ 32.30
82672Assay of estrogen $ 21.70
82677Assay of estriol $ 24.18
82679Assay of estrone $ 24.95
82693Assay of ethylene glycol $ 14.90
82696Assay of etiocholanolone $ 26.24
82705Fats/lipids feces qual $ 5.10
82710Fats/lipids feces quant $ 16.80
82715Assay of fecal fat $ 22.97
82725Assay of blood fatty acids $ 18.77
82726Long chain fatty acids $ 19.75
82728Assay of ferritin $ 13.63
82731Assay of fetal fibronectin $ 64.41
82735Assay of fluoride $ 18.54
82746Assay of folic acid serum $ 14.70
82747Assay of folic acid rbc $ 17.65
82757Assay of semen fructose $ 17.34
82759Assay of rbc galactokinase $ 21.48
82760Assay of galactose $ 11.20
82775Assay galactose transferase $ 21.07
82776Galactose transferase test $ 11.74
82777Galectin-3 $ 44.25
82784Assay iga/igd/igg/igm each $ 9.30
82785Assay of ige $ 16.46
82787Igg 1 2 3 or 4 each $ 8.02
82800Blood ph $ 11.00
82803Blood gases any combination $ 26.07
82805Blood gases w/o2 saturation $ 78.77
82810Blood gases o2 sat only $ 9.77
82820Hemoglobin-oxygen affinity $ 13.34
82930Gastric analy w/ph ea spec $ 6.71
82938Gastrin test $ 17.69
82941Assay of gastrin $ 17.63
82943Assay of glucagon $ 14.29
82945Glucose other fluid $ 3.93
82946Glucagon tolerance test $ 17.77
82947Assay glucose blood quant $ 3.93
82948Reagent strip/blood glucose $ 5.04
82950Glucose test $ 4.75
82951Glucose tolerance test (gtt) $ 12.87
82952Gtt-added samples $ 3.92
82955Assay of g6pd enzyme $ 9.70
82960Test for g6pd enzyme $ 6.05
82962Glucose blood test $ 3.28
82963Assay of glucosidase $ 21.48
82965Assay of gdh enzyme $ 13.15
82977Assay of ggt $ 7.20
82978Assay of glutathione $ 15.45
82979Assay rbc glutathione $ 9.44
82985Assay of glycated protein $ 16.76
83001Assay of gonadotropin (fsh) $ 18.58
83002Assay of gonadotropin (lh) $ 18.52
83003Assay growth hormone (hgh) $ 16.67
83006Growth stimulation gene 2 $ 75.60
83009H pylori (c-13) blood $ 67.36
83010Assay of haptoglobin quant $ 12.58
83012Assay of haptoglobins $ 26.89
83013H pylori (c-13) breath $ 67.36
83014H pylori drug admin $ 7.86
83015Heavy metal qual any anal $ 20.94
83018Heavy metal quant each nes $ 21.96
83020Hemoglobin electrophoresis $ 12.87
83021Hemoglobin chromotography $ 18.06
83026Hemoglobin copper sulfate $ 4.01
83030Hemoglobin f fetal chemical $ 10.74
83033Hemoglobin ftl f assay qual $ 8.00
83036Hemoglobin glycosylated a1c $ 9.71
83037Hb glycosylated a1c home dev $ 9.71
83045Hgb methemoglobin qual $ 6.49
83050Hgb methemoglobin quan $ 8.20
83051Hemoglobin plasma $ 7.31
83060Hgb sulfhemoglobin quan $ 8.80
83065Hemoglobin thermolabile $ 9.00
83068Hemoglobin unstable screen $ 9.47
83069Hemoglobin urine $ 3.95
83070Assay of hemosiderin qual $ 4.75
83080Assay of b hexosaminidase ea $ 16.87
83088Assay of histamine $ 29.53
83090Assay of homocysteine $ 17.92
83150Assay of homovanillic acid $ 22.41
83491Asy hydroxycorticosteroids17 $ 17.90
83497Assay of 5-hiaa $ 12.90
83498Asy hydroxyprogesterone 17-d $ 27.17
83500Assay free hydroxyproline $ 22.65
83505Assay total hydroxyproline $ 24.30
83516Immunoassay nonantibody $ 11.53
83518Immunoassay dipstick $ 9.64
83519Ria nonantibody $ 18.40
83520Immunoassay quant nos nonab $ 17.27
83525Assay of insulin $ 11.43
83527Assay of insulin $ 12.95
83528Assay of intrinsic factor $ 19.82
83540Assay of iron $ 6.47
83550Iron binding test $ 8.74
83570Assay of idh enzyme $ 8.85
83582Assay of ketogenic steroids $ 15.47
83586Assay 17- ketosteroids $ 12.80
83593Fractionation ketosteroids $ 28.50
83605Assay of lactic acid $ 11.57
83615Lactate (ld) (ldh) enzyme $ 6.04
83625Assay of ldh enzymes $ 12.79
83630Lactoferrin fecal (qual) $ 19.70
83631Lactoferrin fecal (quant) $ 19.63
83632Placental lactogen $ 20.22
83633Test urine for lactose $ 11.25
83655Assay of lead $ 12.11
83661L/s ratio fetal lung $ 21.99
83662Foam stability fetal lung $ 18.91
83663Fluoro polarize fetal lung $ 18.91
83664Lamellar bdy fetal lung $ 19.32
83670Assay of lap enzyme $ 9.81
83690Assay of lipase $ 6.89
83695Assay of lipoprotein(a) $ 14.32
83698Assay lipoprotein pla2 $ 46.31
83700Lipopro bld electrophoretic $ 11.26
83701Lipoprotein bld hr fraction $ 33.86
83704Lipoprotein bld quan part $ 34.19
83718Assay of lipoprotein $ 8.19
83719Assay of blood lipoprotein $ 12.75
83721Assay of blood lipoprotein $ 10.50
83727Assay of lrh hormone $ 17.19
83735Assay of magnesium $ 6.70
83775Assay malate dehydrogenase $ 7.37
83785Assay of manganese $ 26.65
83789Mass spectrometry qual/quan $ 24.11
83825Assay of mercury $ 16.26
83835Assay of metanephrines $ 16.94
83857Assay of methemalbumin $ 10.74
83861Microfluid analy tears $ 22.48
83864Mucopolysaccharides $ 28.50
83872Assay synovial fluid mucin $ 5.86
83873Assay of csf protein $ 17.20
83874Assay of myoglobin $ 12.92
83876Assay myeloperoxidase $ 50.86
83880Assay of natriuretic peptide $ 39.26
83883Assay nephelometry not spec $ 13.60
83885Assay of nickel $ 24.51
83915Assay of nucleotidase $ 11.15
83916Oligoclonal bands $ 27.39
83918Organic acids total quant $ 23.60
83919Organic acids qual each $ 16.45
83921Organic acid single quant $ 21.21
83930Assay of blood osmolality $ 6.61
83935Assay of urine osmolality $ 6.82
83937Assay of osteocalcin $ 29.85
83945Assay of oxalate $ 14.45
83950Oncoprotein her-2/neu $ 64.41
83951Oncoprotein dcp $ 64.41
83970Assay of parathormone $ 41.28
83986Assay ph body fluid nos $ 3.58
83987Exhaled breath condensate $ 3.58
83993Assay for calprotectin fecal $ 19.63
84030Assay of blood pku $ 5.50
84035Assay of phenylketones $ 3.98
84060Assay acid phosphatase $ 7.64
84066Assay prostate phosphatase $ 9.66
84075Assay alkaline phosphatase $ 5.18
84078Assay alkaline phosphatase $ 8.26
84080Assay alkaline phosphatases $ 14.78
84081Assay phosphatidylglycerol $ 16.52
84085Assay of rbc pg6d enzyme $ 9.44
84087Assay phosphohexose enzymes $ 10.73
84100Assay of phosphorus $ 4.74
84105Assay of urine phosphorus $ 5.78
84106Test for porphobilinogen $ 5.82
84110Assay of porphobilinogen $ 8.44
84112Eval amniotic fluid protein $ 98.11
84119Test urine for porphyrins $ 13.36
84120Assay of urine porphyrins $ 14.71
84126Assay of feces porphyrins $ 39.11
84132Assay of serum potassium $ 4.76
84133Assay of urine potassium $ 4.73
84134Assay of prealbumin $ 14.59
84135Assay of pregnanediol $ 21.27
84138Assay of pregnanetriol $ 21.05
84140Assay of pregnenolone $ 20.67
84143Assay of 17-hydroxypregneno $ 22.81
84144Assay of progesterone $ 20.86
84145Procalcitonin (pct) $ 27.22
84146Assay of prolactin $ 19.38
84150Assay of prostaglandin $ 41.77
84152Assay of psa complexed $ 18.39
84153Assay of psa total $ 18.39
84154Assay of psa free $ 18.39
84155Assay of protein serum $ 3.67
84156Assay of protein urine $ 3.67
84157Assay of protein other $ 4.00
84160Assay of protein any source $ 5.61
84163Pappa serum $ 15.05
84165Protein e-phoresis serum $ 10.74
84166Protein e-phoresis/urine/csf $ 17.83
84181Western blot test $ 17.03
84182Protein western blot test $ 29.21
84202Assay rbc protoporphyrin $ 14.35
84203Test rbc protoporphyrin $ 9.74
84206Assay of proinsulin $ 26.69
84207Assay of vitamin b-6 $ 28.10
84210Assay of pyruvate $ 14.48
84220Assay of pyruvate kinase $ 9.44
84228Assay of quinine $ 11.63
84233Assay of estrogen $ 87.88
84234Assay of progesterone $ 64.88
84235Assay of endocrine hormone $ 71.23
84238Assay nonendocrine receptor $ 36.57
84244Assay of renin $ 21.99
84252Assay of vitamin b-2 $ 20.24
84255Assay of selenium $ 25.53
84260Assay of serotonin $ 30.98
84270Assay of sex hormone globul $ 21.73
84275Assay of sialic acid $ 13.44
84285Assay of silica $ 25.21
84295Assay of serum sodium $ 4.81
84300Assay of urine sodium $ 5.06
84302Assay of sweat sodium $ 4.86
84305Assay of somatomedin $ 21.26
84307Assay of somatostatin $ 18.28
84311Spectrophotometry $ 8.10
84315Body fluid specific gravity $ 3.28
84375Chromatogram assay sugars $ 39.00
84376Sugars single qual $ 5.50
84377Sugars multiple qual $ 5.50
84378Sugars single quant $ 11.53
84379Sugars multiple quant $ 11.53
84392Assay of urine sulfate $ 5.49
84402Assay of free testosterone $ 25.47
84403Assay of total testosterone $ 25.81
84425Assay of vitamin b-1 $ 21.23
84430Assay of thiocyanate $ 11.63
84431Thromboxane urine $ 35.11
84432Assay of thyroglobulin $ 16.06
84436Assay of total thyroxine $ 6.87
84437Assay of neonatal thyroxine $ 6.47
84439Assay of free thyroxine $ 9.02
84442Assay of thyroid activity $ 14.78
84443Assay thyroid stim hormone $ 16.80
84445Assay of tsi globulin $ 50.86
84446Assay of vitamin e $ 14.18
84449Assay of transcortin $ 18.00
84450Transferase (ast) (sgot) $ 5.18
84460Alanine amino (alt) (sgpt) $ 5.30
84466Assay of transferrin $ 12.76
84478Assay of triglycerides $ 5.74
84479Assay of thyroid (t3 or t4) $ 6.47
84480Assay triiodothyronine (t3) $ 14.18
84481Free assay (ft-3) $ 16.94
84482T3 reverse $ 15.76
84484Assay of troponin quant $ 12.47
84485Assay duodenal fluid trypsin $ 7.20
84488Test feces for trypsin $ 7.30
84490Assay of feces for trypsin $ 9.93
84510Assay of tyrosine $ 10.63
84512Assay of troponin qual $ 10.09
84520Assay of urea nitrogen $ 3.95
84525Urea nitrogen semi-quant $ 5.13
84540Assay of urine/urea-n $ 5.56
84545Urea-n clearance test $ 7.20
84550Assay of blood/uric acid $ 4.52
84560Assay of urine/uric acid $ 5.08
84577Assay of feces/urobilinogen $ 16.80
84578Test urine urobilinogen $ 4.47
84580Assay of urine urobilinogen $ 9.55
84583Assay of urine urobilinogen $ 6.05
84585Assay of urine vma $ 15.50
84586Assay of vip $ 35.33
84588Assay of vasopressin $ 33.94
84590Assay of vitamin a $ 11.61
84591Assay of nos vitamin $ 17.06
84597Assay of vitamin k $ 13.72
84600Assay of volatiles $ 17.11
84620Xylose tolerance test $ 12.91
84630Assay of zinc $ 11.39
84681Assay of c-peptide $ 20.81
84702Chorionic gonadotropin test $ 15.05
84703Chorionic gonadotropin assay $ 7.52
84704Hcg free betachain test $ 15.29
84830Ovulation tests $ 12.70
85002Bleeding time test $ 4.82
85004Automated diff wbc count $ 6.47
85007Bl smear w/diff wbc count $ 3.80
85008Bl smear w/o diff wbc count $ 3.43
85009Manual diff wbc count b-coat $ 5.07
85013Spun microhematocrit $ 7.00
85014Hematocrit $ 2.37
85018Hemoglobin $ 2.37
85025Complete cbc w/auto diff wbc $ 7.77
85027Complete cbc automated $ 6.47
85032Manual cell count each $ 4.31
85041Automated rbc count $ 3.02
85044Manual reticulocyte count $ 4.31
85045Automated reticulocyte count $ 3.99
85046Reticyte/hgb concentrate $ 5.57
85048Automated leukocyte count $ 2.54
85049Automated platelet count $ 4.48
85055Reticulated platelet assay $ 35.74
85130Chromogenic substrate assay $ 11.89
85170Blood clot retraction $ 16.30
85175Blood clot lysis time $ 20.37
85210Clot factor ii prothrom spec $ 12.98
85220Blooc clot factor v test $ 17.65
85230Clot factor vii proconvertin $ 17.90
85240Clot factor viii ahg 1 stage $ 17.90
85244Clot factor viii reltd antgn $ 20.42
85245Clot factor viii vw ristoctn $ 22.94
85246Clot factor viii vw antigen $ 22.94
85247Clot factor viii multimetric $ 22.94
85250Clot factor ix ptc/chrstmas $ 19.04
85260Clot factor x stuart-power $ 17.90
85270Clot factor xi pta $ 17.90
85280Clot factor xii hageman $ 19.35
85290Clot factor xiii fibrin stab $ 16.34
85291Clot factor xiii fibrin scrn $ 9.11
85292Clot factor fletcher fact $ 18.93
85293Clot factor wght kininogen $ 18.93
85300Antithrombin iii activity $ 11.85
85301Antithrombin iii antigen $ 10.81
85302Clot inhibit prot c antigen $ 12.01
85303Clot inhibit prot c activity $ 13.84
85305Clot inhibit prot s total $ 11.61
85306Clot inhibit prot s free $ 15.32
85307Assay activated protein c $ 15.32
85335Factor inhibitor test $ 12.87
85337Thrombomodulin $ 17.27
85345Coagulation time lee & white $ 4.69
85347Coagulation time activated $ 4.28
85348Coagulation time otr method $ 4.49
85360Euglobulin lysis $ 8.41
85362Fibrin degradation products $ 6.89
85366Fibrinogen test $ 80.46
85370Fibrinogen test $ 12.43
85378Fibrin degrade semiquant $ 9.72
85379Fibrin degradation quant $ 10.18
85380Fibrin degradj d-dimer $ 10.18
85384Fibrinogen activity $ 9.72
85385Fibrinogen antigen $ 14.46
85390Fibrinolysins screen i&r $ 15.48
85397Clotting funct activity $ 30.86
85400Fibrinolytic plasmin $ 7.71
85410Fibrinolytic antiplasmin $ 7.71
85415Fibrinolytic plasminogen $ 17.19
85420Fibrinolytic plasminogen $ 6.53
85421Fibrinolytic plasminogen $ 10.18
85441Heinz bodies direct $ 4.20
85445Heinz bodies induced $ 6.82
85460Hemoglobin fetal $ 7.73
85461Hemoglobin fetal $ 9.36
85475Hemolysin acid $ 8.87
85520Heparin assay $ 13.09
85525Heparin neutralization $ 11.84
85530Heparin-protamine tolerance $ 13.09
85536Iron stain peripheral blood $ 6.88
85540Wbc alkaline phosphatase $ 8.60
85547Rbc mechanical fragility $ 8.60
85549Muramidase $ 18.75
85555Rbc osmotic fragility $ 7.47
85557Rbc osmotic fragility $ 13.36
85576Blood platelet aggregation $ 24.91
85597Phospholipid pltlt neutraliz $ 17.98
85598Hexagnal phosph pltlt neutrl $ 17.98
85610Prothrombin time $ 4.29
85611Prothrombin test $ 3.94
85612Viper venom prothrombin time $ 17.49
85613Russell viper venom diluted $ 9.58
85635Reptilase test $ 9.85
85651Rbc sed rate nonautomated $ 4.27
85652Rbc sed rate automated $ 2.70
85660Rbc sickle cell test $ 5.51
85670Thrombin time plasma $ 5.77
85675Thrombin time titer $ 6.85
85705Thromboplastin inhibition $ 9.63
85730Thromboplastin time partial $ 6.01
85732Thromboplastin time partial $ 6.47
85810Blood viscosity examination $ 11.67
86000Agglutinins febrile antigen $ 6.98
86001Allergen specific igg $ 7.82
86003Allg spec ige crude xtrc ea $ 5.22
86005Allg spec ige multiallg scr $ 7.97
86021Wbc antibody identification $ 15.05
86022Platelet antibodies $ 18.37
86023Immunoglobulin assay $ 12.46
86038Antinuclear antibodies $ 12.09
86039Antinuclear antibodies (ana) $ 11.16
86060Antistreptolysin o titer $ 7.30
86063Antistreptolysin o screen $ 5.77
86140C-reactive protein $ 5.18
86141C-reactive protein hs $ 12.95
86146Beta-2 glycoprotein antibody $ 25.45
86147Cardiolipin antibody ea ig $ 25.45
86148Anti-phospholipid antibody $ 16.07
86152Cell enumeration & id $ 250.78
86155Chemotaxis assay $ 15.99
86156Cold agglutinin screen $ 8.07
86157Cold agglutinin titer $ 8.06
86160Complement antigen $ 12.00
86161Complement/function activity $ 12.00
86162Complement total (ch50) $ 20.32
86171Complement fixation each $ 10.01
86200Ccp antibody $ 12.95
86215Deoxyribonuclease antibody $ 13.25
86225Dna antibody native $ 13.74
86226Dna antibody single strand $ 12.11
86235Nuclear antigen antibody $ 17.93
86255Fluorescent antibody screen $ 12.05
86256Fluorescent antibody titer $ 12.05
86277Growth hormone antibody $ 15.74
86280Hemagglutination inhibition $ 8.19
86294Immunoassay tumor qual $ 25.57
86300Immunoassay tumor ca 15-3 $ 20.81
86301Immunoassay tumor ca 19-9 $ 20.81
86304Immunoassay tumor ca 125 $ 20.81
86305Human epididymis protein 4 $ 20.81
86308Heterophile antibody screen $ 5.18
86309Heterophile antibody titer $ 6.47
86310Heterophile antibody absrbj $ 7.37
86316Immunoassay tumor other $ 20.81
86317Immunoassay infectious agent $ 14.99
86318Ia infectious agent antibody $ 18.09
86320Serum immunoelectrophoresis $ 29.92
86325Other immunoelectrophoresis $ 23.13
86327Immunoelectrophoresis assay $ 29.92
86329Immunodiffusion nes $ 14.05
86331Immunodiffusion ouchterlony $ 11.98
86332Immune complex assay $ 24.37
86334Immunofix e-phoresis serum $ 22.34
86335Immunfix e-phorsis/urine/csf $ 29.35
86336Inhibin a $ 15.59
86337Insulin antibodies $ 21.41
86340Intrinsic factor antibody $ 15.08
86341Islet cell antibody $ 23.57
86343Leukocyte histamine release $ 12.46
86344Leukocyte phagocytosis $ 10.39
86352Cell function assay w/stim $ 135.86
86353Lymphocyte transformation $ 49.03
86355B cells total count $ 37.73
86356Mononuclear cell antigen $ 26.78
86357Nk cells total count $ 37.73
86359T cells total count $ 37.73
86360T cell absolute count/ratio $ 46.98
86361T cell absolute count $ 26.78
86367Stem cells total count $ 77.78
86376Microsomal antibody each $ 14.55
86382Neutralization test viral $ 16.91
86384Nitroblue tetrazolium dye $ 13.61
86386Nuclear matrix protein 22 $ 21.78
86403Particle agglut antbdy scrn $ 11.54
86406Particle agglut antbdy titr $ 10.64
86430Rheumatoid factor test qual $ 6.14
86431Rheumatoid factor quant $ 5.67
86480Tb test cell immun measure $ 61.98
86481Tb ag response t-cell susp $ 100.00
86590Streptokinase antibody $ 12.66
86592Syphilis test non-trep qual $ 4.27
86593Syphilis test non-trep quant $ 4.40
86602Antinomyces antibody $ 10.18
86603Adenovirus antibody $ 12.87
86606Aspergillus antibody $ 15.05
86609Bacterium antibody $ 12.88
86611Bartonella antibody $ 10.18
86612Blastomyces antibody $ 12.90
86615Bordetella antibody $ 13.19
86617Lyme disease antibody $ 15.49
86618Lyme disease antibody $ 17.03
86619Borrelia antibody $ 13.38
86622Brucella antibody $ 8.93
86625Campylobacter antibody $ 13.12
86628Candida antibody $ 12.01
86631Chlamydia antibody $ 11.82
86632Chlamydia igm antibody $ 12.68
86635Coccidioides antibody $ 11.47
86638Q fever antibody $ 12.12
86641Cryptococcus antibody $ 14.41
86644Cmv antibody $ 14.39
86645Cmv antibody igm $ 16.85
86648Diphtheria antibody $ 15.21
86651Encephalitis californ antbdy $ 13.19
86652Encephaltis east eqne anbdy $ 13.19
86653Encephaltis st louis antbody $ 13.19
86654Encephaltis west eqne antbdy $ 13.19
86658Enterovirus antibody $ 13.03
86663Epstein-barr antibody $ 13.12
86664Epstein-barr nuclear antigen $ 15.29
86665Epstein-barr capsid vca $ 18.14
86666Ehrlichia antibody $ 10.18
86668Francisella tularensis $ 14.16
86671Fungus nes antibody $ 12.25
86674Giardia lamblia antibody $ 14.72
86677Helicobacter pylori antibody $ 16.85
86682Helminth antibody $ 13.01
86684Hemophilus influenza antibdy $ 15.84
86687Htlv-i antibody $ 9.09
86688Htlv-ii antibody $ 14.00
86689Htlv/hiv confirmj antibody $ 19.35
86692Hepatitis delta agent antbdy $ 17.16
86694Herpes simplex nes antbdy $ 14.39
86695Herpes simplex type 1 test $ 13.19
86696Herpes simplex type 2 test $ 19.35
86698Histoplasma antibody $ 13.79
86701Hiv-1antibody $ 8.89
86702Hiv-2 antibody $ 13.52
86703Hiv-1/hiv-2 1 result antbdy $ 13.71
86704Hep b core antibody total $ 12.05
86705Hep b core antibody igm $ 11.77
86706Hep b surface antibody $ 10.74
86707Hepatitis be antibody $ 11.57
86708Hepatitis a antibody $ 12.39
86709Hepatitis a igm antibody $ 11.26
86710Influenza virus antibody $ 13.55
86711John cunningham antibody $ 16.89
86713Legionella antibody $ 15.30
86717Leishmania antibody $ 12.25
86720Leptospira antibody $ 16.20
86723Listeria monocytogenes $ 13.19
86727Lymph choriomeningitis ab $ 12.87
86732Mucormycosis antibody $ 15.00
86735Mumps antibody $ 13.05
86738Mycoplasma antibody $ 13.24
86741Neisseria meningitidis $ 13.19
86744Nocardia antibody $ 15.99
86747Parvovirus antibody $ 15.03
86750Malaria antibody $ 13.19
86753Protozoa antibody nos $ 12.39
86756Respiratory virus antibody $ 15.89
86757Rickettsia antibody $ 19.35
86759Rotavirus antibody $ 18.23
86762Rubella antibody $ 14.39
86765Rubeola antibody $ 12.88
86768Salmonella antibody $ 13.19
86771Shigella antibody $ 24.48
86774Tetanus antibody $ 14.80
86777Toxoplasma antibody $ 14.39
86778Toxoplasma antibody igm $ 14.41
86780Treponema pallidum $ 13.24
86784Trichinella antibody $ 12.56
86787Varicella-zoster antibody $ 12.88
86788West nile virus ab igm $ 16.85
86789West nile virus antibody $ 14.39
86790Virus antibody nos $ 12.88
86793Yersinia antibody $ 13.19
86800Thyroglobulin antibody $ 15.91
86803Hepatitis c ab test $ 14.27
86804Hep c ab test confirm $ 15.49
86805Lymphocytotoxicity assay $ 189.51
86806Lymphocytotoxicity assay $ 47.59
86807Cytotoxic antibody screening $ 78.65
86808Cytotoxic antibody screening $ 29.68
86812Hla typing a b or c $ 25.81
86813Hla typing a b or c $ 58.00
86816Hla typing dr/dq $ 30.17
86817Hla typing dr/dq $ 106.14
86821Lymphocyte culture mixed $ 36.56
86825Hla x-math non-cytotoxic $ 109.49
86826Hla x-match noncytotoxc addl $ 36.53
86828Hla class i&ii antibody qual $ 64.19
86829Hla class i/ii antibody qual $ 64.19
86830Hla class i phenotype qual $ 95.52
86831Hla class ii phenotype qual $ 81.88
86832Hla class i high defin qual $ 323.75
86833Hla class ii high defin qual $ 325.80
86834Hla class i semiquant panel $ 357.56
86835Hla class ii semiquant panel $ 322.96
86880Coombs test direct $ 5.39
86885Coombs test indirect qual $ 5.72
86886Coombs test indirect titer $ 5.18
86900Blood typing serologic abo $ 2.99
86901Blood typing serologic rh(d) $ 2.99
86902Blood type antigen donor ea $ 6.35
86904Blood typing patient serum $ 16.34
86905Blood typing rbc antigens $ 3.83
86906Bld typing serologic rh phnt $ 7.75
86940Hemolysins/agglutinins auto $ 8.77
86941Hemolysins/agglutinins $ 12.11
87003Small animal inoculation $ 16.84
87015Specimen infect agnt concntj $ 6.68
87040Blood culture for bacteria $ 10.32
87045Feces culture aerobic bact $ 9.44
87046Stool cultr aerobic bact ea $ 9.44
87070Culture othr specimn aerobic $ 8.62
87071Culture aerobic quant other $ 9.89
87073Culture bacteria anaerobic $ 9.66
87075Cultr bacteria except blood $ 9.47
87076Culture anaerobe ident each $ 8.08
87077Culture aerobic identify $ 8.08
87081Culture screen only $ 6.63
87084Culture of specimen by kit $ 27.07
87086Urine culture/colony count $ 8.07
87088Urine bacteria culture $ 8.09
87101Skin fungi culture $ 7.71
87102Fungus isolation culture $ 8.41
87103Blood fungus culture $ 20.46
87106Fungi identification yeast $ 10.32
87107Fungi identification mold $ 10.32
87109Mycoplasma $ 15.39
87110Chlamydia culture $ 19.60
87116Mycobacteria culture $ 10.80
87118Mycobacteric identification $ 14.61
87140Culture type immunofluoresc $ 5.57
87143Culture typing glc/hplc $ 12.52
87147Culture type immunologic $ 5.18
87149Dna/rna direct probe $ 20.05
87150Dna/rna amplified probe $ 35.09
87152Culture type pulse field gel $ 7.74
87153Dna/rna sequencing $ 115.36
87158Culture typing added method $ 7.74
87164Dark field examination $ 10.74
87166Dark field examination $ 11.30
87168Macroscopic exam arthropod $ 4.27
87169Macroscopic exam parasite $ 4.31
87172Pinworm exam $ 4.27
87176Tissue homogenization cultr $ 5.88
87177Ova and parasites smears $ 8.90
87181Microbe susceptible diffuse $ 4.75
87184Microbe susceptible disk $ 7.48
87185Microbe susceptible enzyme $ 4.75
87186Microbe susceptible mic $ 8.65
87187Microbe susceptible mlc $ 40.17
87188Microbe suscept macrobroth $ 6.64
87190Microbe suscept mycobacteri $ 7.31
87197Bactericidal level serum $ 15.02
87205Smear gram stain $ 4.27
87206Smear fluorescent/acid stai $ 5.39
87207Smear special stain $ 5.99
87209Smear complex stain $ 17.98
87210Smear wet mount saline/ink $ 5.82
87220Tissue exam for fungi $ 4.27
87230Assay toxin or antitoxin $ 19.74
87250Virus inoculate eggs/animal $ 19.56
87252Virus inoculation tissue $ 26.07
87253Virus inoculate tissue addl $ 20.20
87254Virus inoculation shell via $ 19.56
87255Genet virus isolate hsv $ 33.86
87260Adenovirus ag if $ 14.43
87265Pertussis ag if $ 11.98
87267Enterovirus antibody dfa $ 13.42
87269Giardia ag if $ 13.61
87270Chlamydia trachomatis ag if $ 11.98
87271Cytomegalovirus dfa $ 13.42
87272Cryptosporidium ag if $ 11.98
87273Herpes simplex 2 ag if $ 11.98
87274Herpes simplex 1 ag if $ 11.98
87275Influenza b ag if $ 12.25
87276Influenza a ag if $ 16.07
87278Legion pneumophilia ag if $ 15.60
87279Parainfluenza ag if $ 16.43
87280Respiratory syncytial ag if $ 13.42
87281Pneumocystis carinii ag if $ 11.98
87283Rubeola ag if $ 60.80
87285Treponema pallidum ag if $ 12.18
87290Varicella zoster ag if $ 13.42
87299Antibody detection nos if $ 16.10
87300Ag detection polyval if $ 11.98
87301Adenovirus ag ia $ 11.98
87305Aspergillus ag ia $ 11.98
87320Chlmyd trach ag ia $ 15.00
87324Clostridium ag ia $ 11.98
87327Cryptococcus neoform ag ia $ 13.42
87328Cryptosporidium ag ia $ 13.82
87329Giardia ag ia $ 11.98
87332Cytomegalovirus ag ia $ 11.98
87335E coli 0157 ag ia $ 12.66
87336Entamoeb hist dispr ag ia $ 16.00
87337Entamoeb hist group ag ia $ 11.98
87338Hpylori stool ag ia $ 14.38
87339H pylori ag ia $ 16.00
87340Hepatitis b surface ag ia $ 10.33
87341Hep b surface ag neutrlzj ia $ 10.33
87350Hepatitis be ag ia $ 11.53
87380Hepatitis delta agent ag ia $ 18.36
87385Histoplasma capsul ag ia $ 13.25
87389Hiv-1 ag w/hiv-1&-2 ab ag ia $ 24.08
87390Hiv-1 ag ia $ 24.06
87391Hiv-2 ag ia $ 21.90
87400Influenza a/b each ag ia $ 14.13
87420Resp syncytial virus ag ia $ 13.91
87425Rotavirus ag ia $ 11.98
87427Shiga-like toxin ag ia $ 11.98
87430Strep a ag ia $ 16.81
87449Nos each organism ag ia $ 11.98
87451Polyvalent mult org ea ag ia $ 10.51
87471Bartonella dna amp probe $ 35.09
87472Bartonella dna quant $ 42.84
87475Lyme dis dna dir probe $ 20.05
87476Lyme dis dna amp probe $ 35.09
87480Candida dna dir probe $ 20.05
87481Candida dna amp probe $ 35.09
87482Candida dna quant $ 55.74
87485Chlmyd pneum dna dir probe $ 20.05
87486Chlmyd pneum dna amp probe $ 35.09
87487Chlmyd pneum dna quant $ 42.84
87490Chlmyd trach dna dir probe $ 22.75
87491Chlmyd trach dna amp probe $ 35.09
87492Chlmyd trach dna quant $ 53.47
87493C diff amplified probe $ 37.27
87495Cytomeg dna dir probe $ 30.03
87496Cytomeg dna amp probe $ 35.09
87497Cytomeg dna quant $ 42.84
87498Enterovirus probe&revrs trns $ 35.09
87500Vanomycin dna amp probe $ 35.09
87501Influenza dna amp prob 1+ $ 51.31
87502Influenza dna amp probe $ 95.80
87503Influenza dna amp prob addl $ 29.22
87505Nfct agent detection gi $ 128.29
87506Iadna-dna/rna probe tq 6-11 $ 262.99
87507Iadna-dna/rna probe tq 12-25 $ 416.78
87510Gardner vag dna dir probe $ 20.05
87511Gardner vag dna amp probe $ 35.09
87512Gardner vag dna quant $ 41.76
87516Hepatitis b dna amp probe $ 35.09
87517Hepatitis b dna quant $ 42.84
87520Hepatitis c rna dir probe $ 31.22
87521Hepatitis c probe&rvrs trnsc $ 35.09
87522Hepatitis c revrs trnscrpj $ 42.84
87525Hepatitis g dna dir probe $ 29.80
87526Hepatitis g dna amp probe $ 39.26
87527Hepatitis g dna quant $ 41.76
87528Hsv dna dir probe $ 20.05
87529Hsv dna amp probe $ 35.09
87530Hsv dna quant $ 42.84
87531Hhv-6 dna dir probe $ 58.00
87532Hhv-6 dna amp probe $ 35.09
87533Hhv-6 dna quant $ 41.76
87534Hiv-1 dna dir probe $ 21.92
87535Hiv-1 probe&reverse trnscrpj $ 35.09
87536Hiv-1 quant&revrse trnscrpj $ 85.10
87537Hiv-2 dna dir probe $ 21.92
87538Hiv-2 probe&revrse trnscripj $ 35.09
87539Hiv-2 quant&revrse trnscripj $ 58.62
87540Legion pneumo dna dir prob $ 20.05
87541Legion pneumo dna amp prob $ 35.09
87542Legion pneumo dna quant $ 41.76
87550Mycobacteria dna dir probe $ 20.05
87551Mycobacteria dna amp probe $ 48.24
87552Mycobacteria dna quant $ 42.84
87555M.tuberculo dna dir probe $ 26.88
87556M.tuberculo dna amp probe $ 41.68
87557M.tuberculo dna quant $ 42.84
87560M.avium-intra dna dir prob $ 27.29
87561M.avium-intra dna amp prob $ 35.09
87562M.avium-intra dna quant $ 42.84
87580M.pneumon dna dir probe $ 20.05
87581M.pneumon dna amp probe $ 35.09
87582M.pneumon dna quant $ 302.62
87590N.gonorrhoeae dna dir prob $ 26.88
87591N.gonorrhoeae dna amp prob $ 35.09
87592N.gonorrhoeae dna quant $ 42.84
87623Hpv low-risk types $ 35.09
87624Hpv high-risk types $ 35.09
87625Hpv types 16 & 18 only $ 40.55
87631Resp virus 3-5 targets $ 142.63
87632Resp virus 6-11 targets $ 218.06
87633Resp virus 12-25 targets $ 416.78
87640Staph a dna amp probe $ 35.09
87641Mr-staph dna amp probe $ 35.09
87650Strep a dna dir probe $ 20.05
87651Strep a dna amp probe $ 35.09
87652Strep a dna quant $ 41.76
87653Strep b dna amp probe $ 35.09
87660Trichomonas vagin dir probe $ 20.05
87661Trichomonas vaginalis amplif $ 35.09
87797Detect agent nos dna dir $ 30.03
87798Detect agent nos dna amp $ 35.09
87799Detect agent nos dna quant $ 42.84
87800Detect agnt mult dna direc $ 43.67
87801Detect agnt mult dna ampli $ 70.20
87802Strep b assay w/optic $ 12.73
87803Clostridium toxin a w/optic $ 16.00
87804Influenza assay w/optic $ 16.55
87806Hiv ag w/hiv1&2 antb w/optic $ 32.77
87807Rsv assay w/optic $ 13.10
87808Trichomonas assay w/optic $ 15.29
87809Adenovirus assay w/optic $ 21.76
87810Chlmyd trach assay w/optic $ 35.29
87850N. gonorrhoeae assay w/optic $ 24.56
87880Strep a assay w/optic $ 16.53
87899Agent nos assay w/optic $ 16.07
87900Phenotype infect agent drug $ 130.35
87901Nfct agt gntyp alys hiv1 rev $ 257.45
87902Nfct agt gntyp alys hep c $ 257.45
87903Phenotype dna hiv w/culture $ 488.66
87904Phenotype dna hiv w/clt add $ 26.07
87905Sialidase enzyme assay $ 12.22
87906Nfct agt gntyp alys hiv1 $ 128.73
87910Nfct agt gntyp alys cmv $ 257.45
87912Nfct agt gntyp alys hep b $ 257.45
88130Sex chromatin identification $ 17.98
88140Sex chromatin identification $ 7.99
88142Cytopath c/v thin layer $ 20.26
88143Cytopath c/v thin layer redo $ 23.04
88147Cytopath c/v automated $ 50.56
88148Cytopath c/v auto rescreen $ 17.31
88150Cytopath c/v manual $ 17.31
88152Cytopath c/v auto redo $ 27.64
88153Cytopath c/v redo $ 24.03
88155Cytopath c/v index add-on $ 14.65
88164Cytopath tbs c/v manual $ 17.31
88165Cytopath tbs c/v redo $ 42.22
88166Cytopath tbs c/v auto redo $ 17.31
88167Cytopath tbs c/v select $ 17.31
88174Cytopath c/v auto in fluid $ 25.37
88175Cytopath c/v auto fluid redo $ 26.61
88230Tissue culture lymphocyte $ 116.49
88233Tissue culture skin/biopsy $ 140.73
88235Tissue culture placenta $ 150.30
88237Tissue culture bone marrow $ 143.75
88239Tissue culture tumor $ 147.52
88240Cell cryopreserve/storage $ 13.07
88241Frozen cell preparation $ 12.09
88245Chromosome analysis 20-25 $ 173.17
88248Chromosome analysis 50-100 $ 173.17
88249Chromosome analysis 100 $ 173.17
88261Chromosome analysis 5 $ 264.34
88262Chromosome analysis 15-20 $ 125.49
88263Chromosome analysis 45 $ 150.29
88264Chromosome analysis 20-25 $ 144.61
88267Chromosome analys placenta $ 188.57
88269Chromosome analys amniotic $ 173.66
88271Cytogenetics dna probe $ 21.42
88272Cytogenetics 3-5 $ 40.70
88273Cytogenetics 10-30 $ 34.81
88274Cytogenetics 25-99 $ 42.38
88275Cytogenetics 100-300 $ 51.19
88280Chromosome karyotype study $ 33.47
88283Chromosome banding study $ 68.60
88285Chromosome count additional $ 26.91
88289Chromosome study additional $ 34.43
88371Protein western blot tissue $ 22.23
88372Protein analysis w/probe $ 26.22
88720Bilirubin total transcut $ 5.02
88738Hgb quant transcutaneous $ 5.02
88740Transcutaneous carboxyhb $ 9.37
88741Transcutaneous methb $ 9.37
89050Body fluid cell count $ 4.72
89051Body fluid cell count $ 5.60
89055Leukocyte assessment fecal $ 4.27
89060Exam synovial fluid crystals $ 7.33
89125Specimen fat stain $ 5.88
89160Exam feces for meat fibers $ 4.85
89190Nasal smear for eosinophils $ 5.79
89300Semen analysis w/huhner $ 9.84
89310Semen analysis w/count $ 8.61
89320Semen anal vol/count/mot $ 12.31
89321Semen anal sperm detection $ 12.05
89322Semen anal strict criteria $ 15.50
89325Sperm antibody test $ 10.67
89329Sperm evaluation test $ 19.59
89330Evaluation cervical mucus $ 10.38
89331Retrograde ejaculation anal $ 19.59
G0027Semen analysis $ 6.50
G0103Psa screening $ 19.31
G0123Screen cerv/vag thin layer $ 20.26
G0143Scr c/v cyto,thinlayer,rescr $ 27.05
G0144Scr c/v cyto,thinlayer,rescr $ 43.97
G0145Scr c/v cyto,thinlayer,rescr $ 26.49
G0147Scr c/v cyto, automated sys $ 17.31
G0148Scr c/v cyto, autosys, rescr $ 31.94
G0306Cbc/diffwbc w/o platelet $ 7.77
G0307Cbc without platelet $ 6.47
G0327Colon ca scrn;bld-bsd biomrk $ -
G0328Fecal blood scrn immunoassay $ 18.05
G0432Eia hiv-1/hiv-2 screen $ 19.57
G0433Elisa hiv-1/hiv-2 screen $ 18.29
G0435Oral hiv-1/hiv-2 screen $ 11.98
G0471Ven blood coll snf/hha $ 10.57
G0476Hpv combo assay ca screen $ 35.09
G0499Hepb screen high risk indiv $ 28.27
G2023#N/A $ -
G2024#N/A $ -
G9143Warfarin respon genetic test $ 120.72

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1 CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

2 This list ONLY includes codes for the following designated health service (DHS) categories: clinical laboratory services. This list DOES NOT include codes for the following DHS categories: physical therapy services, occupational therapy services, outpatient speech-language pathology services, radiology, durable medical equipment and supplies; parenteral and enteral nutrients, equipment and supplies; prosthetics, orthotics, and prosthetic devices and supplies; home health services; outpatient prescription drugs; and inpatient and outpatient hospital services. For the definitions of these DHS categories, refer to §411.351. For more information, refer to the CMS website at http://www.cms.gov/Medicare/Fraud-and-Abuse/PhysicianSelfReferral/List_of_Codes.html.

3 Information in this table should not be used to determine coverage. Phytest does not represent or warrant, whether expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose the results of the CPT Code Lookup Tool (“Results”). Results are provided as “DESCRIPTION” and do not guarantee approval or payment for services.