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See a sample rate comparisonCPT 80076 Fee Schedule
Last Verified: October 2026
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.
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
| 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 | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $8.17 national lab fee schedule rate (2026) · View Medicare rates for 80076 |
| Medicaid Fee Schedule | $8.07 median of the 8 states in the free preview · View Medicaid rates for 80076 |
National average reimbursement for CPT 80076 by major payers:
$7.11
$5.73
$10.29
$11.91
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CPT 80076
5 of 25 sample ratesHigher to lower in this preview
Esoterix, Inc
$16.54Published rateMargarite Bechis
$4.80Published rateSalwa Zahalka
University Physicians Incorporated
$3.43Published rateMonita Poudyal
$3.43Published rateMegan Eliassen
Healogics Specialty Physicians Of Coloradoprofessional LLC
$3.43Published rate
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See a sample payer proposalCPT 80076 vs. Other Organ or Disease Oriented Panels Codes
The CPT 80076 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 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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Frequently Asked Questions
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to describe medical, surgical, and diagnostic services. These codes are essential for standardizing billing and reporting healthcare services to insurance companies and other payers.
To find the cost of a specific medical procedure, it's best to use tools that offer price transparency. For accurate, location-specific pricing information based on CPT codes, you can utilize platforms like Payerprice. Payerprice offers a fee schedule lookup tool that allows you to search for costs using a specific CPT code and your geographic location, helping you understand potential charges.
CMS (Centers for Medicare & Medicaid Services) is a federal agency that administers Medicare and works with states on Medicaid. While CMS publishes some pricing data, it primarily reflects reimbursement rates for federal programs. Payerprice, on the other hand, is a platform that provides a fee schedule lookup tool for users to search for specific medical service prices based on CPT codes and location, often reflecting commercial insurance rates. For specific consumer-level pricing information, especially for commercial plans or self-pay, Payerprice is a more direct resource than CMS data.
Healthcare pricing is complex due to various factors, including the vast number of services, differing agreements between providers and individual insurance companies, regional cost variations, and a lack of a unified, transparent pricing system across the entire industry. This complexity makes it challenging for consumers to easily compare and understand costs, which is why tools like Payerprice are valuable in providing more clarity.
Payerprice's fee schedule lookup tool provides insights into the *negotiated* or *base* prices for services based on CPT codes and location. This information is crucial for estimating costs. However, your exact out-of-pocket costs will ultimately depend on your specific health insurance plan, including factors like your deductible, co-insurance, and co-payment amounts. For the most precise estimate tailored to your plan, you should always confirm with your insurance provider and the healthcare facility.
To use Payerprice, you would typically access their fee schedule lookup tool. In this tool, you can input the specific CPT code for the medical service you are interested in and your geographical location. The platform will then provide you with relevant pricing information, helping you understand the potential cost of that procedure in your specified area.