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 | • Pathology and Laboratory Procedures • Organ or Disease Oriented Panels |
| Common Place of Service | • 81 - Independent Laboratory • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • 90 - Reference Laboratory |
| Complexity Level | Low |
National average reimbursement for CPT 80074 by major payers:
$40.31
$33.88
$56.73
$70.45
| 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 80074 | ||||||
United | 80074 | $23.29 | 1033170808 - MICHAEL SAKELLARIDES | 591685281 - (FL) MICHAEL J SAKELLARIDES MD PA | FL | Otolaryngology Physician (207Y00000X) |
United | 80074 | $23.29 | 1669534012 - BEATRICE BERKES | 10827180 | FL | Dermatology Physician (207N00000X) |
United | 80074 | $20.00 | 1134386980 - SUBHASIS MISRA | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Surgery Physician (208600000X) |
United | 80074 | $20.00 | 1003876053 - MICHAEL ROGERS | 263126631 - (FL) LAKESIDE DERMATOLOGY LLC | FL | Dermatology Physician (207N00000X) |
United | 80074 | $35.09 | 1538456124 - ASHISH THAKKAR | 113465690 | FL | Pulmonary Disease Physician (207RP1001X) |
United | 80074 | $20.00 | 1598022717 - ROGER GASKINS | 593156212 - (FL) FLORIDA MEDICAL CLINIC, LLC | FL | Orthopaedic Hand Surgery Physician (207XS0106X) |
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 | $185.88 | 1952614265 - JOHAN NORDENSTAM | 591680273 - FLORIDA CLINICAL PRACTICE ASSOCIATION INC | FL | Surgery Physician (208600000X) |
United | 80074 | $27.44 | 1659473940 - ERIC DINER | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Urology Physician (208800000X) |
United | 80074 | $20.00 | 1710098173 - BRENT SULLIVAN | 923479126 | FL | Urology Physician (208800000X) |
United | 80074 | $16.67 | 1053542936 - CARLOS TORRE | 850698677 - (FL) SLEEP SNORING SINUS CLINIC OF FLORIDA LLC | FL | Otolaryngology Physician (207Y00000X) |
United | 80074 | $28.13 | 1740349950 - ALISON MOON | 352197601 - (FL) FIRST COAST DERMATOLOGY AND INTERNAL MEDICINE P A | FL | Dermatology Physician (207N00000X) |
United | 80074 | $27.44 | 1669834495 - MING LEE | 824597536 - (FL) DERMATOLOGY OF GAINESVILLE LLC | FL | Dermatology Physician (207N00000X) |
United | 80074 | $28.57 | 1275796310 - CLAIRE PEEPLES | 381899403 - (MI) OAKLAND COLON RECTAL ASSOC P C | FL | Surgery Physician (208600000X) |
United | 80074 | $16.67 | 1295083657 - GLENN R. SINGER, MD, PA | 650822283 - (FL) GLENN R SINGER MD PA | 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 Organ or Disease Oriented Panels Codes
The CPT 80074 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 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 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 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) |
| 86705-CPT | Low | Hepatitis B Core Antibody (Hbcab); Igm Antibody |
| 86709-CPT | Low | Hepatitis A Antibody (Haab); Igm Antibody |
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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