CPT 80074 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 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80074 |
National average reimbursement for CPT 80074 by major payers:

$40.31

$33.88

$56.73

$68.83
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 80074 | $34.02 | 1154815546 - FOREFRONT DERMATOLOGY, S.C., ADVANCED DERMATOLOGY & SKIN CARE CENTRE | 391351587 - FOREFRONT DERMATOLOGY, S.C. | FL | Dermatology Physician (207N00000X) |
United | 80074 | $20.00 | 1013303551 - MARIATU VERLA | 593259553 - ORLANDO HEALTH MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
United | 80074 | $38.93 | 1356316756 - THOMAS CANGIANO | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Urology Physician (208800000X) |
United | 80074 | $93.18 | 1356519409 - MARIANO FARESI | 205733575 | FL | Colon & Rectal Surgery Physician (208C00000X) |
United | 80074 | $28.57 | 1275844870 - RICARDO MOHAMMED | 231352152 - ABINGTON MEMORIAL HOSPITAL | FL | Surgery Physician (208600000X) |
United | 80074 | $27.95 | 1407957400 - BARBARA MONTFORD | 650885726 - BARBARA A MONTFORD | FL | Urology Physician (208800000X) |
United | 80074 | $28.57 | 1437240983 - SCOTT GILBERT | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Urology Physician (208800000X) |
United | 80074 | $27.44 | 1659473940 - ERIC DINER | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Urology Physician (208800000X) |
United | 80074 | $16.67 | 1477094720 - EVANDER MENESES | 141977089 | FL | Surgery Physician (208600000X) |
United | 80074 | $23.29 | 1669534012 - BEATRICE BERKES | 10827180 | FL | Dermatology Physician (207N00000X) |
United | 80074 | $16.67 | 1972925725 - ALEJANDRO PEDROZO III MD PA | 650876932 - (FL) ALEJANDRO PEDROZO III MD PA | FL | Dermatology Physician (207N00000X) |
United | 80074 | $27.29 | 1376518431 - CHARLES WITTEN | 593259553 - ORLANDO HEALTH MEDICAL GROUP INC | FL | Urology Physician (208800000X) |
United | 80074 | $20.00 | 1457919623 - GOODLESS DERMATOLOGY, LLC | 841905435 - (FL) GOODLESS DERMATOLOGY LLC | FL | Dermatology Physician (207N00000X) |
United | 80074 | $23.29 | 1518113893 - LYLE BREEDING MD PLC | 263047029 - (FL) LYLE BREEDING MD PLC | FL | Surgery Physician (208600000X) |
United | 80074 | $20.00 | 1851399885 - JACK RASHKIN | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Pulmonary Disease Physician (207RP1001X) |
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 80074 vs. Other Pathology and Laboratory Procedures Codes
The CPT 80074 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 80074 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 |
|---|---|---|
| 80074-CPT | Low | Acute Hepatitis Panel, Acute Hepatitis Panel This Panel Must Include The Following Hepatitis A Antibody Haab Igm Antibody 86709 Hepatitis B Core Antibody Hbcab Igm Antibody 86705 Hepatitis B Surface Antigen Hbsag 87340 Hepatitis C Antibody 86803 |
| 80076-CPT | Low | Hepatic Function Panel, Hepatic Function Panel This Panel Must Include The Following Albumin 82040 Bilirubin Total 82247 Bilirubin Direct 82248 Phosphatase Alkaline 84075 Protein Total 84155 Transferase Alanine Amino Alt Sgpt 84460 Transferase Aspartate Amino Ast Sgot 84450 |
| 86705-CPT | Low | Hepatitis B Antibody Test, This Blood Test Detects Antibodies For Hepatitis B A Virus That Can Damage The Liver. Test Results Can Indicate A Current Chronic Or Past Infection. They Also Can Indicate Immunity From A Vaccination. |
| 86709-CPT | Low | Hepatitis A Antibody Test, This Test Detects Antibodies For Hepatitis (Hep) A A Virus That Can Damage The Liver. If The Result Is Positive The Infection Is Current Or There Is Immunity From Previous Exposure Or Vaccination. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80074. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80074 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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