CPT 80076 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 TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80076 |
National average reimbursement for CPT 80076 by major payers:
$7.11
$5.73
$10.29
$11.91
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 80076 | $3.43 | 1801087705 - JOSETTE MILLER | 840405257 - CATHOLIC HEALTH INITIATIVES COLORADO | CO | Internal Medicine Physician (207R00000X) |
United | 80076 | $4.80 | 1801049523 - MARIO TOPOLKO | 371509042 | CO | Family Medicine Physician (207Q00000X) |
United | 80076 | $3.43 | 1275734592 - CHERYL STANFORD | 840438224 - PORTERCARE ADVENTIST HEALTH SYSTEM | CO | Family Medicine Physician (207Q00000X) |
United | 80076 | $3.43 | 1386036341 - SALWA ZAHALKA | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Endocrinology, Diabetes & Metabolism Physician (207RE0101X) |
United | 80076 | $3.43 | 1699858225 - KATHERINE HOEKSTRA | 200186252 - (WY) LANDER VALLEY PHYSICIAN PRACTICES LLC | CO | Internal Medicine Physician (207R00000X) |
United | 80076 | $3.43 | 1740480706 - STEPHANIE CHRISTIE | 364778373 - (CO) ONPOINT MEDICAL GROUP, LLC | CO | Family Medicine Physician (207Q00000X) |
United | 80076 | $16.54 | 1215914585 - ESOTERIX, INC | 133802358 | CO | Clinical Medical Laboratory (291U00000X) |
United | 80076 | $3.43 | 1114373990 - SUSAN CREIGHTON | 841343242 | CO | Internal Medicine Physician (207R00000X) |
United | 80076 | $4.80 | 1700315215 - TIMOTHY HUTTON | 582046411 - (GA) HYPERBARIC PHYSICIANS OF GEORGIA | CO | Family Medicine Physician (207Q00000X) |
United | 80076 | $3.43 | 1083233647 - LYNDIE WILKINS PARKER | 205913494 - (CO) NORTHERN COLORADO HOSPITALISTS PLLC | CO | Internal Medicine Physician (207R00000X) |
United | 80076 | $4.90 | 1265525992 - AMY VARBLE | 472266879 - (NE) TELEDIGM PHYSICIAN SERVICES LLC | CO | Family Medicine Physician (207Q00000X) |
United | 80076 | $4.80 | 1609010727 - DAVID LAW | 833835340 - (CA) COMMUNITY CARE MEDICAL CENTER INC | CO | Family Medicine Physician (207Q00000X) |
United | 80076 | $3.43 | 1801232624 - ALLISON POST | 840613289 - (CO) SUNRISE COMMUNITY HEALTH | CO | Family Medicine Physician (207Q00000X) |
United | 80076 | $3.43 | 1205805470 - MONITA POUDYAL | 911491167 | CO | Nephrology Physician (207RN0300X) |
United | 80076 | $8.17 | 1912212093 - JEREMY BROWN | 821816296 - (CO) DYNAMIC FAMILY MEDICINE PLLC | CO | 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 80076 vs. Other Pathology and Laboratory Procedures Codes
The CPT 80076 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 80076 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) |
| 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 |
| 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80076. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80076 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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