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See a sample rate comparisonCPT 80053 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Comprehen Metabolic Panel, Comprehensive Metabolic Panel This Panel Must Include The Following Albumin 82040 Bilirubin Total 82247 Calcium Total 82310 Carbon Dioxide Bicarbonate 82374 Chloride 82435 Creatinine 82565 Glucose 82947 Phosphatase Alkaline 84075 Potassium 84132 Protein Total 84155 Sodium 84295 Transferase Alanine Amino Alt Sgpt 84460 Transferase Aspartate Amino Ast Sgot 84450 Urea Nitrogen Bun 84520
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Organ or Disease Oriented Panels |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 26 - Professional component QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | $10.56 national lab fee schedule rate (2026) · View Medicare rates for 80053 |
| Medicaid Fee Schedule | $10.43 median of the 8 states in the free preview · View Medicaid rates for 80053 |
National average reimbursement for CPT 80053 by major payers:
$10.68
$7.45
$13.42
$15.36
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CPT 80053
5 of 25 sample ratesHigher to lower in this preview
Raymond Hernandez
City Of Hope Medical Foundation
$35.74Published rateSylvia Yoon
City Of Hope Medical Foundation
$30.64Published rateHannah Ellsworth
Association Of University Physicians
$11.82Published rateJames Stoeckle
Dana-Farber Cancer Institute
$3.15Published rateAdam Sperling
Dana-Farber Cancer Institute
$3.15Published rate
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See a sample payer proposalCPT 80053 vs. Other Organ or Disease Oriented Panels Codes
The CPT 80053 code is part of the Pathology and Laboratory Procedures services used for Organ or Disease Oriented Panels. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 80053 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 80047-CPT | Low | Basic Metablc Pnl Ionized Ca, Basic Metabolic Panel (Calcium Ionized) This Panel Must Include The Following: Calcium Ionized (82330) Carbon Dioxide (Bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea Nitrogen (Bun) (84520) |
| 80048-CPT | Low | Basic Metabolic Pnl Total Ca, Basic Metabolic Panel (Calcium Total) This Panel Must Include The Following: Calcium Total (82310) Carbon Dioxide (Bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) Urea Nitrogen (Bun) (84520) |
| 80051-CPT | Low | Electrolyte Testing, An Electrolyte Panel Is A Blood Test That Measures Levels Of Sodium Potassium Chloride And Bicarbonate In The Blood. It Commonly Helps Monitor Medication Effects And Evaluate Kidney Function. |
| 80053-CPT | Low | Comprehen Metabolic Panel, Comprehensive Metabolic Panel This Panel Must Include The Following Albumin 82040 Bilirubin Total 82247 Calcium Total 82310 Carbon Dioxide Bicarbonate 82374 Chloride 82435 Creatinine 82565 Glucose 82947 Phosphatase Alkaline 84075 Potassium 84132 Protein Total 84155 Sodium 84295 Transferase Alanine Amino Alt Sgpt 84460 Transferase Aspartate Amino Ast Sgot 84450 Urea Nitrogen Bun 84520 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80053. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80053 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
To find out the estimated cost of a medical procedure or service, especially when you have a CPT code and specific location in mind, you should use specialized lookup tools. We recommend using Payerprice, which offers a fee schedule lookup tool. This platform allows you to search with a CPT code and your specific location to get detailed pricing information, helping you understand potential costs before a service is rendered.
CPT stands for Current Procedural Terminology. CPT codes are standardized numerical codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are crucial for consistent billing and for understanding the specific service you received. When looking up healthcare costs, knowing the CPT code allows you to get a much more accurate estimate for that particular service in a specific location, often through tools like Payerprice.
Healthcare costs can vary significantly due to several factors, including geographic location, the type of facility (e.g., hospital vs. independent clinic), the specific provider's negotiated rates with different insurance companies, and whether the provider is in-network or out-of-network for your plan. Additionally, the complexity of the patient's condition and additional services required can influence the final price. Using tools like Payerprice can help you compare these varying costs for specific CPT codes in your area.
Insurance companies determine what they will pay for a service based on their negotiated contracts with healthcare providers, which often include a fee schedule for various CPT codes. This fee schedule outlines the maximum amount the insurer will 'allow' for a specific service. Your out-of-pocket costs will then depend on your plan's deductible, copayment, and coinsurance amounts after the allowed amount is determined. To get an idea of typical prices that influence these determinations, resources like Payerprice can provide fee schedule information by CPT code and location.
Several resources are available to help you compare healthcare prices. For detailed, specific pricing information based on CPT codes and your exact location, we recommend using platforms like Payerprice. Payerprice provides a fee schedule lookup tool designed to help consumers understand the costs of medical services. Additionally, your insurance company might offer price comparison tools or provide estimated costs for specific procedures. Always remember to check with your insurance provider for your specific coverage and out-of-pocket costs.