CPT 80069 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 | • Pathology and Laboratory Procedures • Organ or Disease Oriented Panels |
| Common Place of Service | • 81 - Independent Laboratory • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • QW - CLIA Waived Tests |
| Complexity Level | Low |
National average reimbursement for CPT 80069 by major payers:
$8.55
$6.11
$10.89
$12.98
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 80069 | ||||||
United | 80069 | $3.65 | 1467806810 - ZAKARI KWOTA | 822161228 - (CA) CA POST ACUTE SPECIALISTS PC | TX | Internal Medicine Physician (207R00000X) |
United | 80069 | $5.17 | 1659809630 - BRYCE RHODEHOUSE | 820516012 - MOUNTAIN VIEW HOSPITAL LLC | TX | Internal Medicine Physician (207R00000X) |
United | 80069 | $3.65 | 1891176442 - AMR TAKIELDEEN | 822363882 - (TX) LA MAGNA HEALTH PLLC | TX | Family Medicine Physician (207Q00000X) |
United | 80069 | $3.65 | 1346245818 - SCOTT LISSE | 813193170 - VILLAGEMD OF SOUTHEAST TEXAS, PA | TX | Internal Medicine Physician (207R00000X) |
United | 80069 | $3.65 | 1083140578 - KELSEY CARNAHAN | 311756818 - (TX) ASIAN AMERICAN HEALTH COALITION OF THE GREATER HOUSTON AREA | TX | Internal Medicine Physician (207R00000X) |
United | 80069 | $5.21 | 1770593436 - HAN PHAM HULEN | 844515885 - (KS) WOUND INTEGRITY KANSAS PA | TX | Internal Medicine Physician (207R00000X) |
United | 80069 | $9.02 | 1407142904 - ABIHA HUSAIN | 752536818 - HEALTHTEXAS PROVIDER NETWORK | TX | Internal Medicine Physician (207R00000X) |
United | 80069 | $6.19 | 1952593386 - ALISHA KIDANE | 760341804 - (TX) KATY WOMENS CARE P A | TX | Family Medicine Physician (207Q00000X) |
United | 80069 | $5.17 | 1053373951 - REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC | 760423386 - REGIONAL EMPLOYEE ASSISTANCE PROGRA M | TX | Internal Medicine Physician (207R00000X) |
United | 80069 | $3.65 | 1447035951 - PIPPEN HEALTH OF TEXAS, P.A., A TEXAS PROFESSIONAL ASSOCIATION | 843486369 - (TX) PIPPEN HEALTH OF TEXAS PA A TEXAS PROFESSIONAL ASSOCIATION | TX | Internal Medicine Physician (207R00000X) |
United | 80069 | $4.05 | 1659710044 - IYUNOLUWA AGBOOLA | 742932237 - (TX) COMMUNITY MEDICINE ASSOCIATES | TX | Family Medicine Physician (207Q00000X) |
United | 80069 | $3.65 | 1700849353 - GEOFFREY COX | 742978613 - (TX) SOUTH OAKS FAMILY MEDICINE PA | TX | Family Medicine Physician (207Q00000X) |
United | 80069 | $3.65 | 1235246752 - ARUN JAIN | 815200415 - (TX) KALPESH P BHESANIYA MD PA | TX | Internal Medicine Physician (207R00000X) |
United | 80069 | $4.50 | 1700231099 - KARTHIK GURUMURTHY | 454341486 - (TX) MEDICAL CENTER HOSPITALIST ASSOCIATES PLLC | TX | Family Medicine Physician (207Q00000X) |
United | 80069 | $5.09 | 1942205919 - SARA APSLEY-AMBRIZ | 272432685 - (TX) APSLEY MEDICAL GROUP PA | TX | Family Medicine Physician (207Q00000X) |
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 80069 vs. Other Organ or Disease Oriented Panels Codes
The CPT 80069 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 80069 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 Metabolic Panel (Calcium Ionized) This Panel Must Include The Following: Calcium Ionized (82330) Carbon Dioxide (82734) Chloride (82435) Creatinine (82565) Glucose (82947) Potassium (84132) Sodium (84295) And Urea Nitrogen (Bun)(84520) |
| 80048-CPT | Low | 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 Panel This Panel Must Include The Following: Carbon Dioxide (Bicarbonate) (82374) Chloride (82435) Potassium (84132) Sodium (84295) |
| 80069-CPT | Low | Renal Function Panel This Panel Must Include The Following: Albumin (82040) Calcium, Total (82310) Carbon Dioxide (Bicarbonate) (82374) Chloride (82435) Creatinine (82565) Glucose (82947) Phosphorus Inorganic (Phosphate) (84100) Potassium (84132) Sodium (84295) Ure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80069. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80069 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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