CPT 80061 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | Organ or Disease Oriented Panels Pathology and Laboratory Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80061 |
National average reimbursement for CPT 80061 by major payers:

$12.72

$9.53

$17.05

$20.30
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 80061 | $8.02 | 1447504378 - ZESHAN LATIF | 421411630 - IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $11.22 | 1629496195 - MUHAMMAD YOUNUS | 232571699 - TRINITY HEALTH MID-ATLANTIC MEDICAL GROUP F-K-A LANGHORNE PHYSICIAN SE | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $6.09 | 1558453225 - LUIS LUNA | 270352762 - (NJ) DR LUIS F LUNA MD LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $7.86 | 1225425622 - CATHERINE YANG | 591773262 - MCR HEALTH INC | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $9.35 | 1023081338 - ZORAYDA DE LEON | 202326231 | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $6.69 | 1235402967 - MUHAMMAD IJAZ | 263520540 | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $28.17 | 1073038642 - MUHAMMAD AFZAL KHAN | 453023019 - NORTH SHORE-LIJ MEDICAL PC | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $28.17 | 1972182244 - TAQI RIZVI | 453023019 - NORTH SHORE-LIJ MEDICAL PC | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $5.61 | 1336309673 - BRIAN WOLFMAN | 463915494 - (NJ) ALLIED DIGESTIVE HEALTH, LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $13.98 | 1104349372 - KELECHI OMEONU | 453023019 - NORTH SHORE-LIJ MEDICAL PC | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $6.09 | 1891858569 - PAUL ZUKOFF | 223738799 - (NJ) NEW PROVIDENCE INTERNAL MEDICINE ASSOCIATES | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $14.14 | 1104349372 - KELECHI OMEONU | 453023019 - NORTH SHORE-LIJ MEDICAL PC | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $14.03 | 1285895771 - YETUNDE DANIEL | 320442710 | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $43.84 | 1376815647 - SHIVANCK UPADHYAY | 390807065 - ASPIRUS STANLEY HOSPITAL & CLINICS INC | NJ | Internal Medicine Physician (207R00000X) |
United | 80061 | $5.61 | 1124480132 - FAIZ AFRIDI | 463915494 - (NJ) ALLIED DIGESTIVE HEALTH, LLC | NJ | Internal Medicine Physician (207R00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 80061 vs. Other Pathology and Laboratory Procedures Codes
The CPT 80061 code is part of the Organ or Disease Oriented Panels services used for Pathology and Laboratory Procedures. 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 80061 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 |
|---|---|---|
| 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 |
| 80061-CPT | Low | Cholesterol Testing, The Lipid Panel Is A Blood Test That Contains Three Measures: Total Cholesterol Hdl (Good Cholesterol) And Triglycerides. Often Ldl (Bad Cholesterol) Is Calculated From These Results. A Lipid Profile Can Help Evaluate The Risk Of Heart Disease. |
| 82465-CPT | Low | Cholesterol Screening, Total Cholesterol Is Measured From A Blood Sample. Cholesterol Testing Is One Measure Of A Persons Risk For Heart Disease. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80061. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80061 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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