CPT® Code Lookup Tool
LIST OF CPT/HCPCS CODES USED TO DEFINE DESIGNATED HEALTH SERVICE CATEGORY: Clinical Laboratory Services
This code list is effective January 1, 2022
CPT/HCPCS | Description | National Avg. Medicare Reimbursement |
---|---|---|
36415 | Routine venipuncture | $3.00 |
80047 | Metabolic panel ionized ca | $13.73 |
80048 | Metabolic panel total ca | $8.46 |
80051 | Electrolyte panel | $7.01 |
80053 | Comprehen metabolic panel | $10.56 |
80061 | Lipid panel | $13.39 |
80069 | Renal function panel | $8.68 |
80074 | Acute hepatitis panel | $47.63 |
80076 | Hepatic function panel | $8.17 |
80150 | Assay of amikacin | $15.08 |
80155 | Drug screen quant caffeine | $38.57 |
80156 | Assay carbamazepine total | $14.57 |
80157 | Assay carbamazepine free | $13.25 |
80158 | Assay of cyclosporine | $18.05 |
80159 | Drug screen quant clozapine | $20.15 |
80162 | Assay of digoxin | $13.28 |
80163 | Assay of digoxin free | $13.28 |
80164 | Assay dipropylacetic acid | $13.54 |
80165 | Dipropylacetic acid free | $13.54 |
80168 | Assay of ethosuximide | $16.34 |
80169 | Drug screen quant everolimus | $13.73 |
80170 | Assay of gentamicin | $16.38 |
80171 | Drug screen quant gabapentin | $21.67 |
80173 | Assay of haloperidol | $15.78 |
80175 | Drug screen quan lamotrigine | $13.25 |
80176 | Assay of lidocaine | $14.69 |
80177 | Drug scrn quan levetiracetam | $13.25 |
80178 | Assay of lithium | $6.61 |
80180 | Drug scrn quan mycophenolate | $18.05 |
80183 | Drug scrn quant oxcarbazepin | $13.25 |
80184 | Assay of phenobarbital | $15.30 |
80185 | Assay of phenytoin total | $13.25 |
80186 | Assay of phenytoin free | $13.76 |
80188 | Assay of primidone | $16.59 |
80190 | Assay of procainamide | $60.00 |
80192 | Assay of procainamide | $16.75 |
80194 | Assay of quinidine | $14.6 |
80195 | Assay of sirolimus | $13.73 |
80197 | Assay of tacrolimus | $13.73 |
80198 | Assay of theophylline | $14.14 |
80199 | Drug screen quant tiagabine | $27.11 |
80200 | Assay of tobramycin | $16.13 |
80201 | Assay of topiramate | $11.92 |
80202 | Assay of vancomycin | $13.54 |
80203 | Drug screen quant zonisamide | $13.25 |
80299 | Quantitative assay drug | $18.64 |
80400 | Acth stimulation panel | $32.62 |
80402 | Acth stimulation panel | $86.96 |
80406 | Acth stimulation panel | $78.26 |
80408 | Aldosterone suppression eval | $125.5 |
80410 | Calcitonin stimul panel | $80.37 |
80412 | CRH stimulation panel | $801.62 |
80414 | Testosterone response | $51.64 |
80415 | Estradiol response panel | $55.89 |
80416 | Renin stimulation panel | $209.32 |
80417 | Renin stimulation panel | $43.99 |
80418 | Pituitary evaluation panel | $579.48 |
80420 | Dexamethasone panel | $161.88 |
80422 | Glucagon tolerance panel | $46.07 |
80424 | Glucagon tolerance panel | $50.50 |
80426 | Gonadotropin hormone panel | $148.41 |
80428 | Growth hormone panel | $66.70 |
80430 | Growth hormone panel | $129.33 |
80432 | Insulin suppression panel | $165.61 |
80434 | Insulin tolerance panel | $285.03 |
80435 | Insulin tolerance panel | $103.00 |
80436 | Metyrapone panel | $91.16 |
80438 | TRH stimulation panel | $50.41 |
80439 | TRH stimulation panel | $67.21 |
81000 | Urinalysis nonauto w/scope | $4.02 |
81001 | Urinalysis auto w/scope | $3.17 |
81002 | Urinalysis nonauto w/o scope | $3.48 |
81003 | Urinalysis auto w/o scope | $2.25 |
81005 | Urinalysis | $2.17 |
81007 | Urine screen for bacteria | $29.98 |
81015 | Microscopic exam of urine | $3.05 |
81020 | Urinalysis glass test | $4.70 |
81025 | Urine pregnancy test | $8.61 |
81050 | Urinalysis volume measure | $3.64 |
81161 | Dmd dup/delet analysis | $279.00 |
81206 | Bcr/abl1 gene major bp | $163.96 |
81207 | Bcr/abl1 gene minor bp | $144.84 |
81208 | Bcr/abl1 gene other bp | $214.62 |
81210 | Braf gene | $175.4 |
81211 | Brca1&2 seq & com dup/del | N/A |
81212 | Brca1&2 185&5385&6174 var | $440 |
81213 | Brca1&2 uncom dup/del var | N/A |
81214 | Brca1 full seq & com dup/del | N/A |
81215 | Brca1 gene known fam variant | $375.25 |
81217 | Brca2 gene known fam variant | $375.25 |
81225 | Cyp2c19 gene com variants | $291.36 |
81226 | Cyp2d6 gene com variants | $450.91 |
81227 | Cyp2c9 gene com variants | $174.81 |
81235 | Egfr gene com variants | $324.58 |
81240 | F2 gene | $65.69 |
81241 | F5 gene | $73.37 |
81245 | Flt3 gene | $165.51 |
81246 | Flt3 gene analysis | $83.00 |
81256 | Hfe gene | $65.36 |
81261 | Igh gene rearrange amp meth | $197.99 |
81262 | Igh gene rearrang dir probe | $68.55 |
81263 | Igh vari regional mutation | $294.52 |
81264 | Igk rearrangeabn clonal pop | $172.73 |
81265 | Str markers specimen anal | $233.07 |
81267 | Chimerism anal no cell selec | $207.46 |
81268 | Chimerism anal w/cell select | $260.79 |
81270 | Jak2 gene | $91.66 |
81275 | Kras gene | $193.25 |
81287 | Mgmt gene methylation anal | $124.64 |
81288 | Mlh1 gene | $192.32 |
81291 | Mthfr gene | $65.34 |
81292 | Mlh1 gene full seq | $675.40 |
81293 | Mlh1 gene known variants | $331.00 |
81294 | Mlh1 gene dup/delete variant | $202.40 |
81295 | Msh2 gene full seq | $381.70 |
81296 | Msh2 gene known variants | $337.73 |
81297 | Msh2 gene dup/delete variant | $213.30 |
81298 | Msh6 gene full seq | $641.85 |
81299 | Msh6 gene known variants | $308.00 |
81300 | Msh6 gene dup/delete variant | $238.00 |
81301 | Microsatellite instability | $348.56 |
81310 | Npm1 gene | $246.52 |
81313 | Pca3/klk3 antigen | $255.05 |
81315 | Pml/raralpha com breakpoints | $207.31 |
81316 | Pml/raralpha 1 breakpoint | $207.31 |
81317 | Pms2 gene full seq analysis | $676.50 |
81318 | Pms2 known familial variants | $331.00 |
81319 | Pms2 gene dup/delet variants | $203.50 |
81321 | Pten gene full sequence | $600.00 |
81322 | Pten gene known fam variant | $46.60 |
81323 | Pten gene dup/delet variant | $300.00 |
81332 | Serpina1 gene | $43.65 |
81340 | [email protected] gene rearrange amplify | $208.92 |
81341 | [email protected] gene rearrange dirprobe | $49.59 |
81342 | Trg gene rearrangement anal | $201.50 |
81370 | Hla i & ii typing lr | $402.12 |
81371 | Hla i & ii type verify lr | $404.52 |
81372 | Hla i typing complete lr | $403.59 |
81373 | Hla i typing 1 locus lr | $127.43 |
81374 | Hla i typing 1 antigen lr | $74.33 |
81375 | Hla ii typing ag equiv lr | $220.74 |
81376 | Hla ii typing 1 locus lr | $122.22 |
81377 | Hla ii type 1 ag equiv lr | $94.74 |
81378 | Hla i & ii typing hr | $345.57 |
81379 | Hla i typing complete hr | $335.38 |
81380 | Hla i typing 1 locus hr | $177.25 |
81381 | Hla i typing 1 allele hr | $169.90 |
81382 | Hla ii typing 1 loc hr | $123.68 |
81383 | Hla ii typing 1 allele hr | $109.13 |
81410 | Aortic dysfunction/dilation | $504.00 |
81411 | Aortic dysfunction/dilation | $1350.19 |
81415 | Exome sequence analysis | $4780.00 |
81416 | Exome sequence analysis | $12000.00 |
81417 | Exome re-evaluation | $320.00 |
81420 | Fetal chrmoml aneuploidy | $759.05 |
81425 | Genome sequence analysis | $5031.2 |
81426 | Genome sequence analysis | $2709.95 |
81427 | Genome re-evaluation | $2337.65 |
81430 | Hearing loss sequence analys | $1625.00 |
81431 | Hearing loss dup/del analys | $679.57 |
81435 | Hereditary colon cancer | $584.90 |
81436 | Hereditary colon ca synd | $584.90 |
81440 | Mitochondrial gene | $3324.00 |
81445 | Targeted genomic seq analys | $597.91 |
81450 | Targeted genomic seq analys | $759.53 |
81455 | Targeted genomic seq analys | $2919.6 |
81460 | Whole mitochondrial genome | $1287.00 |
81465 | Whole mitochondrial genome | $936.00 |
81470 | X-linked intellectual dblt | $914.00 |
81471 | X-linked intellectual dblt | $914.00 |
81528 | Oncology colorectal scr | $508.87 |
82009 | Test for acetone/ketones | $4.52 |
82010 | Acetone assay | $8.17 |
82013 | Acetylcholinesterase assay | $12.29 |
82016 | Acylcarnitines qual | $16.49 |
82017 | Acylcarnitines quant | $16.87 |
82024 | Assay of acth | $38.62 |
82030 | Assay of adp & amp | $25.80 |
82040 | Assay of serum albumin | $4.95 |
82042 | Assay of urine albumin | $7.78 |
82043 | Microalbumin quantitative | $5.78 |
82044 | Microalbumin semiquant | $6.23 |
82045 | Albumin ischemia modified | $33.94 |
82075 | Assay of breath ethanol | $30.00 |
82085 | Assay of aldolase | $9.71 |
82088 | Assay of aldosterone | $40.75 |
82103 | Alpha-1-antitrypsin total | $13.44 |
82104 | Alpha-1-antitrypsin pheno | $14.46 |
82105 | Alpha-fetoprotein serum | $16.77 |
82106 | Alpha-fetoprotein amniotic | $17.00 |
82107 | Alpha-fetoprotein l3 | $64.41 |
82108 | Assay of aluminum | $25.48 |
82120 | Amines vaginal fluid qual | $5.99 |
82127 | Amino acid single qual | $14.18 |
82128 | Amino acids mult qual | $13.87 |
82131 | Amino acids single quant | $22.98 |
82135 | Assay aminolevulinic acid | $16.45 |
82136 | Amino acids quant 2-5 | $19.61 |
82139 | Amino acids quan 6 or more | $16.87 |
82140 | Assay of ammonia | $14.57 |
82143 | Amniotic fluid scan | $9.35 |
82150 | Assay of amylase | $6.48 |
82154 | Androstanediol glucuronide | $28.83 |
82157 | Assay of androstenedione | $29.28 |
82160 | Assay of androsterone | $25.55 |
82163 | Assay of angiotensin II | $20.52 |
82164 | Angiotensin I enzyme test | $14.60 |
82172 | Assay of apolipoprotein | $21.09 |
82175 | Assay of arsenic | $18.97 |
82180 | Assay of ascorbic acid | $9.89 |
82190 | Atomic absorption | $15.90 |
82232 | Assay of beta-2 protein | $16.18 |
82239 | Bile acids total | $17.12 |
82240 | Bile acids cholylglycine | $26.58 |
82247 | Bilirubin total | $5.02 |
82248 | Bilirubin direct | $5.02 |
82252 | Fecal bilirubin test | $4.56 |
82261 | Assay of biotinidase | $16.87 |
82270 | Occult blood feces | $4.38 |
82271 | Occult blood other sources | $5.32 |
82272 | Occult bld feces 1-3 tests | $4.23 |
82274 | Assay test for blood fecal | $15.92 |
82286 | Assay of bradykinin | $5.16 |
82300 | Assay of cadmium | $23.64 |
82306 | Vitamin d 25 hydroxy | $29.60 |
82308 | Assay of calcitonin | $26.79 |
82310 | Assay of calcium | $5.16 |
82330 | Assay of calcium | $13.68 |
82331 | Calcium infusion test | $13.34 |
82340 | Assay of calcium in urine | $6.03 |
82355 | Calculus analysis qual | $11.58 |
82360 | Calculus assay quant | $12.87 |
82365 | Calculus spectroscopy | $12.90 |
82370 | X-ray assay calculus | $12.52 |
82373 | Assay c-d transfer measure | $18.06 |
82374 | Assay blood carbon dioxide | $4.88 |
82375 | Assay carboxyhb quant | $12.32 |
82376 | Assay carboxyhb qual | $14.07 |
82378 | Carcinoembryonic antigen | $18.96 |
82379 | Assay of carnitine | $16.87 |
82380 | Assay of carotene | $9.22 |
82382 | Assay urine catecholamines | $27.30 |
82383 | Assay blood catecholamines | $29.08 |
82384 | Assay three catecholamines | $25.25 |
82387 | Assay of cathepsin-d | $18.06 |
82390 | Assay of ceruloplasmin | $10.74 |
82397 | Chemiluminescent assay | $14.12 |
82415 | Assay of chloramphenicol | $12.67 |
82435 | Assay of blood chloride | $4.60 |
82436 | Assay of urine chloride | $5.75 |
82438 | Assay other fluid chlorides | $5.00 |
82441 | Test for chlorohydrocarbons | $6.01 |
82465 | Assay bld/serum cholesterol | $4.35 |
82480 | Assay serum cholinesterase | $7.87 |
82482 | Assay rbc cholinesterase | $9.81 |
82485 | Assay chondroitin sulfate | $20.65 |
82495 | Assay of chromium | $20.28 |
82507 | Assay of citrate | $27.80 |
82523 | Collagen crosslinks | $18.68 |
82525 | Assay of copper | $12.41 |
82528 | Assay of corticosterone | $22.52 |
82530 | Cortisol free | $16.71 |
82533 | Total cortisol | $16.30 |
82540 | Assay of creatine | $4.64 |
82542 | Column chromotography quant | $24.09 |
82550 | Assay of ck (cpk) | $6.51 |
82552 | Assay of cpk in blood | $13.39 |
82553 | Creatine mb fraction | $11.55 |
82554 | Creatine isoforms | $11.87 |
82565 | Assay of creatinine | $5.12 |
82570 | Assay of urine creatinine | $5.18 |
82575 | Creatinine clearance test | $9.46 |
82585 | Assay of cryofibrinogen | $14.14 |
82595 | Assay of cryoglobulin | $6.47 |
82600 | Assay of cyanide | $19.4 |
82607 | Vitamin B-12 | $15.08 |
82608 | B-12 binding capacity | $14.32 |
82610 | Cystatin c | $18.52 |
82615 | Test for urine cystines | $9.55 |
82626 | Dehydroepiandrosterone | $25.27 |
82627 | Dehydroepiandrosterone | $22.23 |
82633 | Desoxycorticosterone | $30.98 |
82634 | Deoxycortisol | $29.28 |
82638 | Assay of dibucaine number | $12.25 |
82652 | Vit d 1 25-dihydroxy | $38.50 |
82656 | Pancreatic elastase fecal | $11.53 |
82657 | Enzyme cell activity | $22.17 |
82658 | Enzyme cell activity ra | $44.03 |
82664 | Electrophoretic test | $61.50 |
82668 | Assay of erythropoietin | $18.79 |
82670 | Assay of estradiol | $27.94 |
82671 | Assay of estrogens | $32.30 |
82672 | Assay of estrogen | $21.70 |
82677 | Assay of estriol | $24.18 |
82679 | Assay of estrone | $24.95 |
82693 | Assay of ethylene glycol | $14.90 |
82696 | Assay of etiocholanolone | $26.24 |
82705 | Fats/lipids feces qual | $5.10 |
82710 | Fats/lipids feces quant | $16.80 |
82715 | Assay of fecal fat | $22.97 |
82725 | Assay of blood fatty acids | $18.77 |
82726 | Long chain fatty acids | $19.75 |
82728 | Assay of ferritin | $13.63 |
82731 | Assay of fetal fibronectin | $64.41 |
82735 | Assay of fluoride | $18.54 |
82746 | Blood folic acid serum | $14.70 |
82747 | Assay of folic acid rbc | $17.65 |
82757 | Assay of semen fructose | $17.34 |
82759 | Assay of rbc galactokinase | $21.48 |
82760 | Assay of galactose | $11.20 |
82775 | Assay galactose transferase | $21.07 |
82776 | Galactose transferase test | $11.74 |
82777 | Galectin-3 | $44.25 |
82784 | Assay iga/igd/igg/igm each | $9.30 |
82785 | Assay of ige | $16.46 |
82787 | Igg 1 2 3 or 4 each | $8.02 |
82800 | Blood pH | $11.00 |
82803 | Blood gases any combination | $26.07 |
82805 | Blood gases w/o2 saturation | $78.77 |
82810 | Blood gases o2 sat only | $9.77 |
82820 | Hemoglobin-oxygen affinity | $13.34 |
82930 | Gastric analy w/ph ea spec | $6.71 |
82938 | Gastrin test | $17.69 |
82941 | Assay of gastrin | $17.63 |
82943 | Assay of glucagon | $14.29 |
82945 | Glucose other fluid | $3.93 |
82946 | Glucagon tolerance test | $17.77 |
82947 | Assay glucose blood quant | $3.93 |
82948 | Reagent strip/blood glucose | $5.04 |
82950 | Glucose test | $4.75 |
82951 | Glucose tolerance test (GTT) | $12.87 |
82952 | GTT-added samples | $3.92 |
82955 | Assay of g6pd enzyme | $9.70 |
82960 | Test for G6PD enzyme | $6.05 |
82962 | Glucose blood test | $3.28 |
82963 | Assay of glucosidase | $21.48 |
82965 | Assay of gdh enzyme | $13.15 |
82977 | Assay of GGT | $7.20 |
82978 | Assay of glutathione | $15.45 |
82979 | Assay rbc glutathione | $9.44 |
82985 | Glycated protein | $16.76 |
83001 | Gonadotropin (FSH) | $18.58 |
83002 | Gonadotropin (LH) | $18.52 |
83003 | Assay growth hormone (hgh) | $16.67 |
83006 | Growth stimulation gene 2 | $75.60 |
83009 | H pylori (c-13) blood | $67.36 |
83010 | Assay of haptoglobin quant | $12.58 |
83012 | Assay of haptoglobins | $26.89 |
83013 | H pylori (c-13) breath | $67.36 |
83014 | H pylori drug admin | $7.86 |
83015 | Heavy metal screen | $20.94 |
83018 | Quantitative screen metals | $21.96 |
83020 | Hemoglobin electrophoresis | $12.87 |
83021 | Hemoglobin chromotography | $18.06 |
83026 | Hemoglobin copper sulfate | $4.01 |
83030 | Fetal hemoglobin chemical | $10.74 |
83033 | Fetal hemoglobin assay qual | $8.00 |
83036 | Glycosylated hemoglobin test | $9.71 |
83037 | Glycosylated hb home device | $9.71 |
83045 | Blood methemoglobin test | $6.49 |
83050 | Blood methemoglobin assay | $8.200 |
83051 | Assay of plasma hemoglobin | $7.31 |
83060 | Blood sulfhemoglobin assay | $8.80 |
83065 | Assay of hemoglobin heat | $9.00 |
83068 | Hemoglobin stability screen | $9.47 |
83069 | Assay of urine hemoglobin | $3.95 |
83070 | Assay of hemosiderin qual | $4.75 |
83080 | Assay of b hexosaminidase | $16.87 |
83088 | Assay of histamine | $29.53 |
83090 | Assay of homocystine | $17.92 |
83150 | Assay of for hva | $22.41 |
83491 | Assay of corticosteroids | $17.90 |
83497 | Assay of 5-hiaa | $12.90 |
83498 | Assay of progesterone | $27.17 |
83500 | Assay free hydroxyproline | $22.65 |
83505 | Assay total hydroxyproline | $24.3 |
83516 | Immunoassay nonantibody | $11.53 |
83518 | Immunoassay dipstick | $9.64 |
83519 | Ria nonantibody | $18.40 |
83520 | Immunoassay quant nos nonab | $17.27 |
83525 | Assay of insulin | $11.43 |
83527 | Assay of insulin | $12.95 |
83528 | Assay of intrinsic factor | $19.82 |
83540 | Assay of iron | $6.47 |
83550 | Iron binding test | $8.74 |
83570 | Assay of idh enzyme | $8.85 |
83582 | Assay of ketogenic steroids | $15.47 |
83586 | Assay 17- ketosteroids | $12.80 |
83593 | Fractionation ketosteroids | $28.50 |
83605 | Assay of lactic acid | $11.57 |
83615 | Lactate (LD) (LDH) enzyme | $6.04 |
83625 | Assay of ldh enzymes | $12.79 |
83630 | Lactoferrin fecal (qual) | $19.70 |
83631 | Lactoferrin fecal (quant) | $19.63 |
83632 | Placental lactogen | $20.22 |
83633 | Test urine for lactose | $11.25 |
83655 | Assay of lead | $12.11 |
83661 | L/s ratio fetal lung | $21.99 |
83662 | Foam stability fetal lung | $18.91 |
83663 | Fluoro polarize fetal lung | $18.91 |
83664 | Lamellar bdy fetal lung | $19.32 |
83670 | Assay of lap enzyme | $9.81 |
83690 | Assay of lipase | $6.89 |
83695 | Assay of lipoprotein(a) | $14.32 |
83698 | Assay lipoprotein pla2 | $46.31 |
83700 | Lipopro bld electrophoretic | $11.26 |
83701 | Lipoprotein bld hr fraction | $33.86 |
83704 | Lipoprotein bld by nmr | $34.19 |
83718 | Assay of lipoprotein | $8.19 |
83719 | Assay of blood lipoprotein | $12.75 |
83721 | Assay of blood lipoprotein | $10.50 |
83727 | Assay of lrh hormone | $17.19 |
83735 | Assay of magnesium | $6.70 |
83775 | Assay of md enzyme | $7.37 |
83785 | Assay of manganese | $26.65 |
83789 | Mass spectrometry quant | $24.11 |
83825 | Assay of mercury | $16.26 |
83835 | Assay of metanephrines | $16.94 |
83857 | Assay of methemalbumin | $10.74 |
83861 | Microfluid analy tears | $22.48 |
83864 | Mucopolysaccharides | $28.50 |
83872 | Assay synovial fluid mucin | $5.86 |
83873 | Assay of csf protein | $17.2 |
83874 | Assay of myoglobin | $12.92 |
83876 | Assay myeloperoxidase | $50.86 |
83880 | Natriuretic peptide | $39.26 |
83883 | Assay nephelometry not spec | $13.60 |
83885 | Assay of nickel | $24.51 |
83915 | Assay of nucleotidase | $11.15 |
83916 | Oligoclonal bands | $27.39 |
83918 | Organic acids total quant | $23.60 |
83919 | Organic acids qual each | $16.45 |
83921 | Organic acid single quant | $21.21 |
83930 | Assay of blood osmolality | $6.61 |
83935 | Assay of urine osmolality | $6.82 |
83937 | Assay of osteocalcin | $29.85 |
83945 | Assay of oxalate | $14.45 |
83950 | Oncoprotein her-2/neu | $64.41 |
83951 | Oncoprotein dcp | $64.41 |
83970 | Assay of parathormone | $41.28 |
83986 | Assay ph body fluid nos | $3.58 |
83987 | Exhaled breath condensate | $3.58 |
83993 | Assay for calprotectin fecal | $19.63 |
84030 | Assay of blood pku | $5.50 |
84035 | Assay of phenylketones | $3.98 |
84060 | Assay acid phosphatase | $7.64 |
84066 | Assay prostate phosphatase | $9.66 |
84075 | Assay alkaline phosphatase | $5.18 |
84078 | Assay alkaline phosphatase | $8.26 |
84080 | Assay alkaline phosphatases | $14.78 |
84081 | Amniotic fluid enzyme test | $16.52 |
84085 | Assay of rbc pg6d enzyme | $9.44 |
84087 | Assay phosphohexose enzymes | $10.73 |
84100 | Assay of phosphorus | $4.74 |
84105 | Assay of urine phosphorus | $5.78 |
84106 | Test for porphobilinogen | $5.82 |
84110 | Assay of porphobilinogen | $8.44 |
84112 | Placenta alpha micro ig c/v | $98.11 |
84119 | Test urine for porphyrins | $13.36 |
84120 | Assay of urine porphyrins | $14.71 |
84126 | Assay of feces porphyrins | $39.11 |
84132 | Assay of serum potassium | $4.76 |
84133 | Assay of urine potassium | $4.73 |
84134 | Assay of prealbumin | $14.59 |
84135 | Assay of pregnanediol | $21.27 |
84138 | Assay of pregnanetriol | $21.05 |
84140 | Assay of pregnenolone | $20.67 |
84143 | Assay of 17-hydroxypregneno | $22.81 |
84144 | Assay of progesterone | $20.86 |
84145 | Procalcitonin (pct) | $27.22 |
84146 | Assay of prolactin | $19.38 |
84150 | Assay of prostaglandin | $41.77 |
84152 | Assay of psa complexed | $18.39 |
84153 | Assay of psa total | $18.39 |
84154 | Assay of psa free | $18.39 |
84155 | Assay of protein serum | $3.67 |
84156 | Assay of protein urine | $3.67 |
84157 | Assay of protein other | $4.00 |
84160 | Assay of protein any source | $5.61 |
84163 | Pappa serum | $15.05 |
84165 | Protein e-phoresis serum | $10.74 |
84166 | Protein e-phoresis/urine/csf | $17.83 |
84181 | Western blot test | $17.03 |
84182 | Protein western blot test | $29.21 |
84202 | Assay RBC protoporphyrin | $14.35 |
84203 | Test RBC protoporphyrin | $9.74 |
84206 | Assay of proinsulin | $26.69 |
84207 | Assay of vitamin b-6 | $28.10 |
84210 | Assay of pyruvate | $14.48 |
84220 | Assay of pyruvate kinase | $9.44 |
84228 | Assay of quinine | $11.63 |
84233 | Assay of estrogen | $87.88 |
84234 | Assay of progesterone | $64.88 |
84235 | Assay of endocrine hormone | $71.23 |
84238 | Assay nonendocrine receptor | $36.57 |
84244 | Assay of renin | $21.99 |
84252 | Assay of vitamin b-2 | $20.24 |
84255 | Assay of selenium | $25.53 |
84260 | Assay of serotonin | $30.98 |
84270 | Assay of sex hormone globul | $21.73 |
84275 | Assay of sialic acid | $13.44 |
84285 | Assay of silica | $25.21 |
84295 | Assay of serum sodium | $4.81 |
84300 | Assay of urine sodium | $5.06 |
84302 | Assay of sweat sodium | $4.86 |
84305 | Assay of somatomedin | $21.26 |
84307 | Assay of somatostatin | $18.28 |
84311 | Spectrophotometry | $8.10 |
84315 | Body fluid specific gravity | $3.28 |
84375 | Chromatogram assay sugars | $39.00 |
84376 | Sugars single qual | $5.50 |
84377 | Sugars multiple qual | $5.50 |
84378 | Sugars single quant | $11.53 |
84379 | Sugars multiple quant | $11.53 |
84392 | Assay of urine sulfate | $5.49 |
84402 | Assay of testosterone | $25.47 |
84403 | Assay of total testosterone | $25.81 |
84425 | Assay of vitamin b-1 | $21.23 |
84430 | Assay of thiocyanate | $11.63 |
84431 | Thromboxane urine | $35.11 |
84432 | Assay of thyroglobulin | $16.06 |
84436 | Assay of total thyroxine | $6.87 |
84437 | Assay of neonatal thyroxine | $6.47 |
84439 | Assay of free thyroxine | $9.02 |
84442 | Assay of thyroid activity | $14.78 |
84443 | Assay thyroid stim hormone | $16.80 |
84445 | Assay of tsi | $50.86 |
84446 | Assay of vitamin e | $14.18 |
84449 | Assay of transcortin | $18.00 |
84450 | Transferase (AST) (SGOT) | $5.18 |
84460 | Alanine amino (ALT) (SGPT) | $5.30 |
84466 | Assay of transferrin | $12.76 |
84478 | Assay of triglycerides | $5.74 |
84479 | Assay of thyroid (t3 or t4) | $6.47 |
84480 | Assay triiodothyronine (t3) | $14.18 |
84481 | Free assay (FT-3) | $16.94 |
84482 | T3 reverse | $15.76 |
84484 | Assay of troponin quant | $12.47 |
84485 | Assay duodenal fluid trypsin | $7.20 |
84488 | Test feces for trypsin | $7.30 |
84490 | Assay of feces for trypsin | $9.93 |
84510 | Assay of tyrosine | $10.63 |
84512 | Assay of troponin qual | $10.09 |
84520 | Assay of urea nitrogen | $3.95 |
84525 | Urea nitrogen semi-quant | $5.13 |
84540 | Assay of urine/urea-n | $5.56 |
84545 | Urea-N clearance test | $7.20 |
84550 | Assay of blood/uric acid | $4.52 |
84560 | Assay of urine/uric acid | $5.08 |
84577 | Assay of feces/urobilinogen | $16.80 |
84578 | Test urine urobilinogen | $4.47 |
84580 | Assay of urine urobilinogen | $9.55 |
84583 | Assay of urine urobilinogen | $6.05 |
84585 | Assay of urine vma | $15.5 |
84586 | Assay of vip | $35.33 |
84588 | Assay of vasopressin | $33.94 |
84590 | Assay of vitamin a | $11.61 |
84591 | Assay of nos vitamin | $17.06 |
84597 | Assay of vitamin k | $13.72 |
84600 | Assay of volatiles | $17.11 |
84620 | Xylose tolerance test | $12.91 |
84630 | Assay of zinc | $11.39 |
84681 | Assay of c-peptide | $20.81 |
84702 | Chorionic gonadotropin test | $15.05 |
84703 | Chorionic gonadotropin assay | $7.52 |
84704 | Hcg free betachain test | $15.29 |
84830 | Ovulation tests | $12.7 |
85002 | Bleeding time test | $4.82 |
85004 | Automated diff wbc count | $6.47 |
85007 | Bl smear w/diff wbc count | $3.80 |
85008 | Bl smear w/o diff wbc count | $3.43 |
85009 | Manual diff wbc count b-coat | $5.07 |
85013 | Spun microhematocrit | $7.00 |
85014 | Hematocrit | $2.37 |
85018 | Hemoglobin | $2.37 |
85025 | Complete cbc w/auto diff wbc | $7.77 |
85027 | Complete cbc automated | $6.47 |
85032 | Manual cell count each | $4.31 |
85041 | Automated rbc count | $3.02 |
85044 | Manual reticulocyte count | $4.31 |
85045 | Automated reticulocyte count | $3.99 |
85046 | Reticyte/hgb concentrate | $5.57 |
85048 | Automated leukocyte count | $2.54 |
85049 | Automated platelet count | $4.48 |
85055 | Reticulated platelet assay | $35.74 |
85130 | Chromogenic substrate assay | $11.89 |
85170 | Blood clot retraction | $16.3 |
85175 | Blood clot lysis time | $20.37 |
85210 | Blood clot factor II test | $12.98 |
85220 | Blood clot factor V test | $17.65 |
85230 | Blood clot factor VII test | $17.90 |
85240 | Blood clot factor VIII test | $17.90 |
85244 | Blood clot factor VIII test | $20.42 |
85245 | Blood clot factor VIII test | $22.94 |
85246 | Blood clot factor VIII test | $22.94 |
85247 | Blood clot factor VIII test | $22.94 |
85250 | Blood clot factor IX test | $19.04 |
85260 | Blood clot factor X test | $17.90 |
85270 | Blood clot factor XI test | $17.90 |
85280 | Blood clot factor XII test | $19.35 |
85290 | Blood clot factor XIII test | $16.34 |
85291 | Blood clot factor XIII test | $9.11 |
85292 | Blood clot factor assay | $18.93 |
85293 | Blood clot factor assay | $18.93 |
85300 | Antithrombin III test | $11.85 |
85301 | Antithrombin III test | $10.81 |
85302 | Blood clot inhibitor antigen | $12.01 |
85303 | Blood clot inhibitor test | $13.84 |
85305 | Blood clot inhibitor assay | $11.61 |
85306 | Blood clot inhibitor test | $15.32 |
85307 | Assay activated protein c | $15.32 |
85335 | Factor inhibitor test | $12.87 |
85337 | Thrombomodulin | $17.27 |
85345 | Coagulation time | $4.69 |
85347 | Coagulation time | $4.28 |
85348 | Coagulation time | $4.49 |
85360 | Euglobulin lysis | $8.41 |
85362 | Fibrin degradation products | $6.89 |
85366 | Fibrinogen test | $80.46 |
85370 | Fibrinogen test | $12.43 |
85378 | Fibrin degrade semiquant | $9.72 |
85379 | Fibrin degradation quant | $10.18 |
85380 | Fibrin degradation vte | $10.18 |
85384 | Fibrinogen | $9.72 |
85385 | Fibrinogen | $14.46 |
85390 | Fibrinolysins screen | $15.48 |
85397 | Clotting funct activity | $30.86 |
85400 | Fibrinolytic plasmin | $7.71 |
85410 | Fibrinolytic antiplasmin | $7.71 |
85415 | Fibrinolytic plasminogen | $17.19 |
85420 | Fibrinolytic plasminogen | $6.53 |
85421 | Fibrinolytic plasminogen | $10.18 |
85441 | Heinz bodies direct | $4.20 |
85445 | Heinz bodies induced | $6.82 |
85460 | Hemoglobin fetal | $7.73 |
85461 | Hemoglobin fetal | $9.36 |
85475 | Hemolysin | $8.87 |
85520 | Heparin assay | $13.09 |
85525 | Heparin neutralization | $11.84 |
85530 | Heparin-protamine tolerance | $13.09 |
85536 | Iron stain peripheral blood | $6.88 |
85540 | Wbc alkaline phosphatase | $8.60 |
85547 | RBC mechanical fragility | $8.60 |
85549 | Muramidase | $18.75 |
85555 | RBC osmotic fragility | $7.47 |
85557 | RBC osmotic fragility | $13.36 |
85576 | Blood platelet aggregation | $24.91 |
85597 | Phospholipid pltlt neutraliz | $17.98 |
85598 | Hexagnal phosph pltlt neutrl | $17.98 |
85610 | Prothrombin time | $4.29 |
85611 | Prothrombin test | $3.94 |
85612 | Viper venom prothrombin time | $17.49 |
85613 | Russell viper venom diluted | $9.58 |
85635 | Reptilase test | $9.85 |
85651 | Rbc sed rate nonautomated | $4.27 |
85652 | Rbc sed rate automated | $2.70 |
85660 | RBC sickle cell test | $5.51 |
85670 | Thrombin time plasma | $5.77 |
85675 | Thrombin time titer | $6.85 |
85705 | Thromboplastin inhibition | $9.63 |
85730 | Thromboplastin time partial | $6.01 |
85732 | Thromboplastin time partial | $6.47 |
85810 | Blood viscosity examination | $11.67 |
86000 | Agglutinins febrile | $6.98 |
86001 | Allergen specific igg | $7.82 |
86003 | Allergen specific IgE | $5.22 |
86005 | Allergen specific IgE | $7.97 |
86021 | WBC antibody identification | $15.05 |
86022 | Platelet antibodies | $18.37 |
86023 | Immunoglobulin assay | $12.46 |
86038 | Antinuclear antibodies | $12.09 |
86039 | Antinuclear antibodies (ANA) | $11.16 |
86060 | Antistreptolysin o titer | $7.30 |
86063 | Antistreptolysin o screen | $5.77 |
86140 | C-reactive protein | $5.18 |
86141 | C-reactive protein hs | $12.95 |
86146 | Glycoprotein antibody | $25.45 |
86147 | Cardiolipin antibody | $25.45 |
86148 | Phospholipid antibody | $16.07 |
86152 | Cell enumeration &id | $250.78 |
86155 | Chemotaxis assay | $15.99 |
86156 | Cold agglutinin screen | $8.07 |
86157 | Cold agglutinin titer | $8.06 |
86160 | Complement antigen | $12.00 |
86161 | Complement/function activity | $12.00 |
86162 | Complement total (ch50) | $20.32 |
86171 | Complement fixation each | $10.01 |
86200 | Ccp antibody | $12.95 |
86215 | Deoxyribonuclease antibody | $13.25 |
86225 | DNA antibody | $13.74 |
86226 | Dna antibody single strand | $12.11 |
86235 | Nuclear antigen antibody | $17.93 |
86255 | Fluorescent antibody screen | $12.05 |
86256 | Fluorescent antibody titer | $12.05 |
86277 | Growth hormone antibody | $15.74 |
86280 | Hemagglutination inhibition | $8.19 |
86294 | Immunoassay tumor qual | $25.57 |
86300 | Immunoassay tumor ca 15-3 | $20.81 |
86301 | Immunoassay tumor ca 19-9 | $20.81 |
86304 | Immunoassay tumor ca 125 | $20.81 |
86305 | Human epididymis protein 4 | $20.81 |
86308 | Heterophile antibodies | $5.18 |
86309 | Heterophile antibodies | $6.47 |
86310 | Heterophile antibodies | $7.37 |
86316 | Immunoassay tumor other | $20.81 |
86317 | Immunoassay infectious agent | $14.99 |
86318 | Immunoassay infectious agent | $18.09 |
86320 | Serum immunoelectrophoresis | $29.92 |
86325 | Other immunoelectrophoresis | $23.13 |
86327 | Immunoelectrophoresis assay | $29.92 |
86329 | Immunodiffusion | $14.05 |
86331 | Immunodiffusion ouchterlony | $11.98 |
86332 | Immune complex assay | $24.37 |
86334 | Immunofix e-phoresis serum | $22.34 |
86335 | Immunfix e-phorsis/urine/csf | $29.35 |
86336 | Inhibin A | $15.59 |
86337 | Insulin antibodies | $21.41 |
86340 | Intrinsic factor antibody | $15.08 |
86341 | Islet cell antibody | $23.57 |
86343 | Leukocyte histamine release | $12.46 |
86344 | Leukocyte phagocytosis | $10.39 |
86352 | Cell function assay w/stim | $135.86 |
86353 | Lymphocyte transformation | $49.03 |
86355 | B cells total count | $37.73 |
86356 | Mononuclear cell antigen | $26.78 |
86357 | Nk cells total count | $37.73 |
86359 | T cells total count | $37.73 |
86360 | T cell absolute count/ratio | $46.98 |
86361 | T cell absolute count | $26.78 |
86367 | Stem cells total count | $77.78 |
86376 | Microsomal antibody | $14.55 |
86382 | Neutralization test viral | $16.91 |
86384 | Nitroblue tetrazolium dye | $13.61 |
86386 | Nuclear matrix protein 22 | $21.78 |
86403 | Particle agglutination test | $11.54 |
86406 | Particle agglutination test | $10.64 |
86430 | Rheumatoid factor test | $6.14 |
86431 | Rheumatoid factor quant | $5.67 |
86480 | Tb test cell immun measure | $61.98 |
86481 | Tb ag response t-cell susp | $100 |
86590 | Streptokinase antibody | $12.66 |
86592 | Syphilis test non-trep qual | $4.27 |
86593 | Syphilis test non-trep quant | $4.40 |
86602 | Antinomyces antibody | $10.18 |
86603 | Adenovirus antibody | $12.87 |
86606 | Aspergillus antibody | $15.05 |
86609 | Bacterium antibody | $12.88 |
86611 | Bartonella antibody | $10.18 |
86612 | Blastomyces antibody | $12.9 |
86615 | Bordetella antibody | $13.19 |
86617 | Lyme disease antibody | $15.49 |
86618 | Lyme disease antibody | $17.03 |
86619 | Borrelia antibody | $13.38 |
86622 | Brucella antibody | $8.93 |
86625 | Campylobacter antibody | $13.12 |
86628 | Candida antibody | $12.01 |
86631 | Chlamydia antibody | $11.82 |
86632 | Chlamydia igm antibody | $12.68 |
86635 | Coccidioides antibody | $11.47 |
86638 | Q fever antibody | $12.12 |
86641 | Cryptococcus antibody | $14.41 |
86644 | CMV antibody | $14.39 |
86645 | Cmv antibody igm | $16.85 |
86648 | Diphtheria antibody | $15.21 |
86651 | Encephalitis antibody | $13.19 |
86652 | Encephalitis antibody | $13.19 |
86653 | Encephalitis antibody | $13.19 |
86654 | Encephalitis antibody | $13.19 |
86658 | Enterovirus antibody | $13.03 |
86663 | Epstein-barr antibody | $13.12 |
86664 | Epstein-barr antibody | $15.29 |
86665 | Epstein-barr antibody | $18.14 |
86666 | Ehrlichia antibody | $10.18 |
86668 | Francisella tularensis | $14.16 |
86671 | Fungus antibody | $12.25 |
86674 | Giardia lamblia antibody | $14.72 |
86677 | Helicobacter pylori | $16.85 |
86682 | Helminth antibody | $13.01 |
86684 | Hemophilus influenza | $15.84 |
86687 | Htlv-i antibody | $9.09 |
86688 | Htlv-ii antibody | $14.00 |
86689 | HTLV/HIV confirmatory test | $19.35 |
86692 | Hepatitis delta agent | $17.16 |
86694 | Herpes simplex test | $14.39 |
86695 | Herpes simplex test | $13.19 |
86696 | Herpes simplex type 2 | $19.35 |
86698 | Histoplasma | $13.79 |
86701 | HIV-1 | $8.89 |
86702 | HIV-2 | $13.52 |
86703 | Hiv-1/hiv-2 single result | $13.71 |
86704 | Hep b core antibody total | $12.05 |
86705 | Hep b core antibody igm | $11.77 |
86706 | Hep b surface antibody | $10.74 |
86707 | Hep be antibody | $11.57 |
86708 | Hep a antibody total | $12.39 |
86709 | Hep a antibody igm | $11.26 |
86710 | Influenza virus antibody | $13.55 |
86711 | John cunningham antibody | $16.89 |
86713 | Legionella antibody | $15.30 |
86717 | Leishmania antibody | $12.25 |
86720 | Leptospira antibody | $16.20 |
86723 | Listeria monocytogenes ab | $13.19 |
86727 | Lymph choriomeningitis ab | $12.87 |
86732 | Mucormycosis antibody | $15.00 |
86735 | Mumps antibody | $13.05 |
86738 | Mycoplasma antibody | $13.24 |
86741 | Neisseria meningitidis | $13.19 |
86744 | Nocardia antibody | $15.99 |
86747 | Parvovirus antibody | $15.03 |
86750 | Malaria antibody | $13.19 |
86753 | Protozoa antibody nos | $12.39 |
86756 | Respiratory virus antibody | $15.89 |
86757 | Rickettsia antibody | $19.35 |
86759 | Rotavirus antibody | $18.23 |
86762 | Rubella antibody | $14.39 |
86765 | Rubeola antibody | $12.88 |
86768 | Salmonella antibody | $13.19 |
86771 | Shigella antibody | $24.48 |
86774 | Tetanus antibody | $14.80 |
86777 | Toxoplasma antibody | $14.39 |
86778 | Toxoplasma antibody igm | $14.41 |
86780 | Treponema pallidum | $13.24 |
86784 | Trichinella antibody | $12.56 |
86787 | Varicella-zoster antibody | $12.88 |
86788 | West nile virus ab igm | $16.85 |
86789 | West nile virus antibody | $14.39 |
86790 | Virus antibody nos | $12.88 |
86793 | Yersinia antibody | $13.19 |
86800 | Thyroglobulin antibody | $15.91 |
86803 | Hepatitis c ab test | $14.27 |
86804 | Hep c ab test confirm | $15.49 |
86805 | Lymphocytotoxicity assay | $189.51 |
86806 | Lymphocytotoxicity assay | $47.59 |
86807 | Cytotoxic antibody screening | $78.65 |
86808 | Cytotoxic antibody screening | $29.68 |
86812 | Hla typing a b or c | $25.81 |
86813 | Hla typing a b or c | $58.00 |
86816 | Hla typing dr/dq | $30.17 |
86817 | Hla typing dr/dq | $106.14 |
86821 | Lymphocyte culture mixed | $36.56 |
86825 | Hla x-math non-cytotoxic | $109.49 |
86826 | Hla x-match noncytotoxc addl | $36.53 |
86828 | Hla class i&ii antibody qual | $64.19 |
86829 | Hla class i/ii antibody qual | $64.19 |
86830 | Hla class i phenotype qual | $95.52 |
86831 | Hla class ii phenotype qual | $81.88 |
86832 | Hla class i high defin qual | $323.75 |
86833 | Hla class ii high defin qual | $325.8 |
86834 | Hla class i semiquant panel | $357.56 |
86835 | Hla class ii semiquant panel | $322.96 |
86880 | Coombs test direct | $5.39 |
86885 | Coombs test indirect qual | $5.72 |
86886 | Coombs test indirect titer | $5.18 |
86900 | Blood typing abo | $2.99 |
86901 | Blood typing rh (d) | $2.99 |
86902 | Blood type antigen donor ea | $6.35 |
86904 | Blood typing patient serum | $16.34 |
86905 | Blood typing rbc antigens | $3.83 |
86906 | Blood typing rh phenotype | $7.75 |
86940 | Hemolysins/agglutinins auto | $8.77 |
86941 | Hemolysins/agglutinins | $12.11 |
87003 | Small animal inoculation | $16.84 |
87015 | Specimen concentration | $6.68 |
87040 | Blood culture for bacteria | $10.32 |
87045 | Feces culture bacteria | $9.44 |
87046 | Stool cultr bacteria each | $9.44 |
87070 | Culture bacteria other | $8.62 |
87071 | Culture bacteri aerobic othr | $9.89 |
87073 | Culture bacteria anaerobic | $9.66 |
87075 | Cultr bacteria except blood | $9.47 |
87076 | Culture anaerobe ident each | $8.08 |
87077 | Culture aerobic identify | $8.08 |
87081 | Culture screen only | $6.63 |
87084 | Culture of specimen by kit | $27.07 |
87086 | Urine culture/colony count | $8.07 |
87088 | Urine bacteria culture | $8.09 |
87101 | Skin fungi culture | $7.71 |
87102 | Fungus isolation culture | $8.41 |
87103 | Blood fungus culture | $20.46 |
87106 | Fungi identification yeast | $10.32 |
87107 | Fungi identification mold | $10.32 |
87109 | Mycoplasma | $15.39 |
87110 | Chlamydia culture | $19.60 |
87116 | Mycobacteria culture | $10.80 |
87118 | Mycobacteric identification | $14.61 |
87140 | Culture type immunofluoresc | $5.57 |
87143 | Culture typing glc/hplc | $12.52 |
87147 | Culture type immunologic | $5.18 |
87149 | Dna/rna direct probe | $20.05 |
87150 | Dna/rna amplified probe | $35.09 |
87152 | Culture type pulse field gel | $7.74 |
87153 | Dna/rna sequencing | $115.36 |
87158 | Culture typing added method | $7.74 |
87164 | Dark field examination | $10.74 |
87166 | Dark field examination | $11.30 |
87168 | Macroscopic exam arthropod | $4.27 |
87169 | Macroscopic exam parasite | $4.31 |
87172 | Pinworm exam | $4.27 |
87176 | Tissue homogenization cultr | $5.88 |
87177 | Ova and parasites smears | $8.90 |
87181 | Microbe susceptible diffuse | $4.75 |
87184 | Microbe susceptible disk | $7.48 |
87185 | Microbe susceptible enzyme | $4.75 |
87186 | Microbe susceptible mic | $8.65 |
87187 | Microbe susceptible mlc | $40.17 |
87188 | Microbe suscept macrobroth | $6.64 |
87190 | Microbe suscept mycobacteri | $7.31 |
87197 | Bactericidal level serum | $15.02 |
87205 | Smear gram stain | $4.27 |
87206 | Smear fluorescent/acid stai | $5.39 |
87207 | Smear special stain | $5.99 |
87209 | Smear complex stain | $17.98 |
87210 | Smear wet mount saline/ink | $5.82 |
87220 | Tissue exam for fungi | $4.27 |
87230 | Assay toxin or antitoxin | $19.74 |
87250 | Virus inoculate eggs/animal | $19.56 |
87252 | Virus inoculation tissue | $26.07 |
87253 | Virus inoculate tissue addl | $20.20 |
87254 | Virus inoculation shell via | $19.56 |
87255 | Genet virus isolate hsv | $33.86 |
87260 | Adenovirus ag if | $14.43 |
87265 | Pertussis ag if | $11.98 |
87267 | Enterovirus antibody dfa | $13.42 |
87269 | Giardia ag if | $13.61 |
87270 | Chlamydia trachomatis ag if | $11.98 |
87271 | Cytomegalovirus dfa | $13.42 |
87272 | Cryptosporidium ag if | $11.98 |
87273 | Herpes simplex 2 ag if | $11.98 |
87274 | Herpes simplex 1 ag if | $11.98 |
87275 | Influenza b ag if | $12.25 |
87276 | Influenza a ag if | $16.07 |
87278 | Legion pneumophilia ag if | $15.60 |
87279 | Parainfluenza ag if | $16.43 |
87280 | Respiratory syncytial ag if | $13.42 |
87281 | Pneumocystis carinii ag if | $11.98 |
87283 | Rubeola ag if | $60.80 |
87285 | Treponema pallidum ag if | $12.18 |
87290 | Varicella zoster ag if | $13.42 |
87299 | Antibody detection nos if | $16.10 |
87300 | Ag detection polyval if | $11.98 |
87301 | Adenovirus ag eia | $11.98 |
87305 | Aspergillus ag eia | $11.98 |
87320 | Chylmd trach ag eia | $15.00 |
87324 | Clostridium ag eia | $11.98 |
87327 | Cryptococcus neoform ag eia | $13.42 |
87328 | Cryptosporidium ag eia | $13.82 |
87329 | Giardia ag eia | $11.98 |
87332 | Cytomegalovirus ag eia | $11.98 |
87335 | E coli 0157 ag eia | $12.66 |
87336 | Entamoeb hist dispr ag eia | $16.00 |
87337 | Entamoeb hist group ag eia | $11.98 |
87338 | Hpylori stool eia | $14.38 |
87339 | H pylori ag eia | $16.00 |
87340 | Hepatitis b surface ag eia | $10.33 |
87341 | Hepatitis b surface ag eia | $10.33 |
87350 | Hepatitis be ag eia | $11.53 |
87380 | Hepatitis delta ag eia | $18.36 |
87385 | Histoplasma capsul ag eia | $13.25 |
87389 | Hiv-1 ag w/hiv-1 & hiv-2 ab | $24.08 |
87390 | Hiv-1 ag eia | $24.06 |
87391 | Hiv-2 ag eia | $21.90 |
87400 | Influenza a/b ag eia | $14.13 |
87420 | Resp syncytial ag eia | $13.91 |
87425 | Rotavirus ag eia | $11.98 |
87427 | Shiga-like toxin ag eia | $11.98 |
87430 | Strep a ag eia | $16.81 |
87449 | Ag detect nos eia mult | $11.98 |
87450 | Ag detect nos eia single | N/A |
87451 | Ag detect polyval eia mult | $10.51 |
87471 | Bartonella dna amp probe | $35.09 |
87472 | Bartonella dna quant | $42.84 |
87475 | Lyme dis dna dir probe | $20.05 |
87476 | Lyme dis dna amp probe | $35.09 |
87480 | Candida dna dir probe | $20.05 |
87481 | Candida dna amp probe | $35.09 |
87482 | Candida dna quant | $55.74 |
87485 | Chylmd pneum dna dir probe | $20.05 |
87486 | Chylmd pneum dna amp probe | $35.09 |
87487 | Chylmd pneum dna quant | $42.84 |
87490 | Chylmd trach dna dir probe | $22.75 |
87491 | Chylmd trach dna amp probe | $35.09 |
87492 | Chylmd trach dna quant | $53.47 |
87493 | C diff amplified probe | $37.27 |
87495 | Cytomeg dna dir probe | $30.03 |
87496 | Cytomeg dna amp probe | $35.09 |
87497 | Cytomeg dna quant | $42.84 |
87498 | Enterovirus dna amp probe | $35.09 |
87500 | Vanomycin dna amp probe | $35.09 |
87501 | Influenza dna amp prob 1+ | $51.31 |
87502 | Influenza dna amp probe | $95.80 |
87503 | Influenza dna amp prob addl | $29.22 |
87505 | Nfct agent detection gi | $128.29 |
87506 | Iadna-dna/rna probe tq 6-11 | $262.99 |
87507 | Iadna-dna/rna probe tq 12-25 | $416.78 |
87510 | Gardner vag dna dir probe | $20.05 |
87511 | Gardner vag dna amp probe | $35.09 |
87512 | Gardner vag dna quant | $41.76 |
87516 | Hepatitis b dna amp probe | $35.09 |
87517 | Hepatitis b dna quant | $42.84 |
87520 | Hepatitis c rna dir probe | $31.22 |
87521 | Hepatitis c rna amp probe | $35.09 |
87522 | Hepatitis c rna quant | $42.84 |
87525 | Hepatitis g dna dir probe | $29.80 |
87526 | Hepatitis g dna amp probe | $39.26 |
87527 | Hepatitis g dna quant | $41.76 |
87528 | Hsv dna dir probe | $20.05 |
87529 | Hsv dna amp probe | $35.09 |
87530 | Hsv dna quant | $42.84 |
87531 | Hhv-6 dna dir probe | $58.00 |
87532 | Hhv-6 dna amp probe | $35.09 |
87533 | Hhv-6 dna quant | $41.76 |
87534 | Hiv-1 dna dir probe | $21.92 |
87535 | Hiv-1 dna amp probe | $35.09 |
87536 | Hiv-1 dna quant | $85.10 |
87537 | Hiv-2 dna dir probe | $21.92 |
87538 | Hiv-2 dna amp probe | $35.09 |
87539 | Hiv-2 dna quant | $58.62 |
87540 | Legion pneumo dna dir prob | $20.05 |
87541 | Legion pneumo dna amp prob | $35.09 |
87542 | Legion pneumo dna quant | $41.76 |
87550 | Mycobacteria dna dir probe | $20.05 |
87551 | Mycobacteria dna amp probe | $48.24 |
87552 | Mycobacteria dna quant | $42.84 |
87555 | M.tuberculo dna dir probe | $26.88 |
87556 | M.tuberculo dna amp probe | $41.68 |
87557 | M.tuberculo dna quant | $42.84 |
87560 | M.avium-intra dna dir prob | $27.29 |
87561 | M.avium-intra dna amp prob | $35.09 |
87562 | M.avium-intra dna quant | $42.84 |
87580 | M.pneumon dna dir probe | $20.05 |
87581 | M.pneumon dna amp probe | $35.09 |
87582 | M.pneumon dna quant | $302.62 |
87590 | N.gonorrhoeae dna dir prob | $26.88 |
87591 | N.gonorrhoeae dna amp prob | $35.09 |
87592 | N.gonorrhoeae dna quant | $42.84 |
87623 | Hpv low-risk types | $35.09 |
87624 | Hpv high-risk types | $35.09 |
87625 | Hpv types 16 & 18 only | $40.55 |
87631 | Resp virus 3-11 targets | $142.63 |
87632 | Resp virus 6-11 targets | $218.06 |
87633 | Resp virus 12-25 targets | $416.78 |
87640 | Staph a dna amp probe | $35.09 |
87641 | Mr-staph dna amp probe | $35.09 |
87650 | Strep a dna dir probe | $20.05 |
87651 | Strep a dna amp probe | $35.09 |
87652 | Strep a dna quant | $41.76 |
87653 | Strep b dna amp probe | $35.09 |
87660 | Trichomonas vagin dir probe | $20.05 |
87661 | Trichomonas vaginalis amplif | $35.09 |
87797 | Detect agent nos dna dir | $30.03 |
87798 | Detect agent nos dna amp | $35.09 |
87799 | Detect agent nos dna quant | $42.84 |
87800 | Detect agnt mult dna direc | $43.67 |
87801 | Detect agnt mult dna ampli | $70.20 |
87802 | Strep b assay w/optic | $12.73 |
87803 | Clostridium toxin a w/optic | $16.00 |
87804 | Influenza assay w/optic | $16.55 |
87806 | Hiv antigen w/hiv antibodies | $32.77 |
87807 | Rsv assay w/optic | $13.10 |
87808 | Trichomonas assay w/optic | $15.29 |
87809 | Adenovirus assay w/optic | $21.76 |
87810 | Chylmd trach assay w/optic | $35.29 |
87850 | N. gonorrhoeae assay w/optic | $24.56 |
87880 | Strep a assay w/optic | $16.53 |
87899 | Agent nos assay w/optic | $16.07 |
87900 | Phenotype infect agent drug | $130.35 |
87901 | Genotype dna hiv reverse t | $257.45 |
87902 | Genotype dna hepatitis c | $257.45 |
87903 | Phenotype dna hiv w/culture | $488.66 |
87904 | Phenotype dna hiv w/clt add | $26.07 |
87905 | Sialidase enzyme assay | $12.22 |
87906 | Genotype dna hiv reverse t | $128.73 |
87910 | Genotype cytomegalovirus | $257.45 |
87912 | Genotype dna hepatitis b | $257.45 |
88130 | Sex chromatin identification | $17.98 |
88140 | Sex chromatin identification | $7.99 |
88142 | Cytopath c/v thin layer | $20.26 |
88143 | Cytopath c/v thin layer | $23.04 |
88147 | Cytopath c/v automated | $50.56 |
88148 | Cytopath c/v auto rescreen | $16.00 |
88150 | Cytopath c/v manual | $15.92 |
88152 | Cytopath c/v auto | $27.64 |
88153 | Cytopath c/v | $24.03 |
88155 | Cytopath c/v index add-on | $14.65 |
88164 | Cytopath tbs c/v manual | $15.92 |
88165 | Cytopath tbs c/v | $42.22 |
88166 | Cytopath tbs c/v auto | $15.92 |
88167 | Cytopath tbs c/v select | $15.92 |
88174 | Cytopath c/v auto in fluid | $25.37 |
88175 | Cytopath c/v auto fluid | $26.61 |
88230 | Tissue culture lymphocyte | $116.49 |
88233 | Tissue culture skin/biopsy | $140.73 |
88235 | Tissue culture placenta | $150.30 |
88237 | Tissue culture bone marrow | $143.75 |
88239 | Tissue culture tumor | $147.52 |
88240 | Cell cryopreserve/storage | $13.07 |
88241 | Frozen cell preparation | $12.09 |
88245 | Chromosome analysis 20-25 | $173.17 |
88248 | Chromosome analysis 50-100 | $173.17 |
88249 | Chromosome analysis 100 | $173.17 |
88261 | Chromosome analysis 5 | $264.34 |
88262 | Chromosome analysis 15-20 | $125.49 |
88263 | Chromosome analysis 45 | $150.29 |
88264 | Chromosome analysis 20-25 | $144.61 |
88267 | Chromosome analys placenta | $188.57 |
88269 | Chromosome analys amniotic | $173.66 |
88271 | Cytogenetics dna probe | $21.42 |
88272 | Cytogenetics 3-5 | $40.70 |
88273 | Cytogenetics 10-30 | $34.81 |
88274 | Cytogenetics 25-99 | $42.38 |
88275 | Cytogenetics 100-300 | $51.19 |
88280 | Chromosome karyotype study | $33.47 |
88283 | Chromosome banding study | $68.60 |
88285 | Chromosome count additional | $26.91 |
88289 | Chromosome study additional | $34.43 |
88371 | Protein western blot tissue | $22.23 |
88372 | Protein analysis w/probe | $26.22 |
88720 | Bilirubin total transcut | $5.02 |
88738 | Hgb quant transcutaneous | $5.02 |
88740 | Transcutaneous carboxyhb | $9.37 |
88741 | Transcutaneous methb | $9.37 |
89050 | Body fluid cell count | $4.72 |
89051 | Body fluid cell count | $5.6 |
89055 | Leukocyte assessment fecal | $4.27 |
89060 | Exam synovial fluid crystals | $7.33 |
89125 | Specimen fat stain | $5.88 |
89160 | Exam feces for meat fibers | $4.85 |
89190 | Nasal smear for eosinophils | $5.79 |
89300 | Semen analysis w/huhner | $9.84 |
89310 | Semen analysis w/count | $8.61 |
89320 | Semen anal vol/count/mot | $12.31 |
89321 | Semen anal sperm detection | $12.05 |
89322 | Semen anal strict criteria | $15.5 |
89325 | Sperm antibody test | $10.67 |
89329 | Sperm evaluation test | $19.59 |
89330 | Evaluation cervical mucus | $10.38 |
89331 | Retrograde ejaculation anal | $19.59 |
G0027 | Semen analysis | $6.50 |
G0103 | Psa screening | $19.31 |
G0123 | Screen cerv/vag thin layer | $20.26 |
G0143 | Scr c/v cyto,thinlayer,rescr | $27.05 |
G0144 | Scr c/v cyto,thinlayer,rescr | $43.97 |
G0145 | Scr c/v cyto,thinlayer,rescr | $26.49 |
G0147 | Scr c/v cyto, automated sys | $15.92 |
G0148 | Scr c/v cyto, autosys, rescr | $31.94 |
G0306 | CBC/diffwbc w/o platelet | $7.77 |
G0307 | Cbc without platelet | $6.47 |
G0327 | Colon ca scrn;bld-bsd biomrk | N/A |
G0328 | Fecal blood scrn immunoassay | $18.05 |
G0432 | Eia hiv-1/hiv-2 screen | $19.57 |
G0433 | Elisa hiv-1/hiv-2 screen | $18.29 |
G0435 | Oral hiv-1/hiv-2 screen | $11.98 |
G0471 | Ven blood coll SNF/HHA | $5.00 |
G0476 | Hpv combo assay ca screen | $35.09 |
G0499 | HepB screen high risk indiv | $28.27 |
G2023 | Specimen collect covid-19 | $23.46 |
G2024 | Spec coll snf/lab covid-19 | $25.46 |
G9143 | Warfarin 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.
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