CPT 80081 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 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80081 |
National average reimbursement for CPT 80081 by major payers:
$65.04
$52.61
$79.28
$126.08
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 80081 | $48.65 | 1871162834 - AHS HOSPITAL CORP, AHS CONSOLIDATED LABS | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Clinical Medical Laboratory (291U00000X) |
United | 80081 | $102.59 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 80081 | $44.92 | 1861650780 - CHILDRENS NATIONAL MEDICAL CENTER | 530196580 - CHILDRENS HOSPITAL | DC | Children's Hospital (282NC2000X) |
United | 80081 | $84.83 | 1184809220 - AHS HOSPITAL CORP | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Case Management Agency (251B00000X) |
United | 80081 | $31.44 | 1366428401 - AARON ASKEW | 931261079 - THE ORTHOPEDIC AND NEUROSURGICAL CENTER OF THE CASCADES | OR | Orthopaedic Trauma Physician (207XX0801X) |
United | 80081 | $44.92 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 80081 | $101.97 | 1619910627 - BRADLEY WEISNER | 562107759 - UROLOGY SPECIALISTS OF THE CAROLINAS, PLLC | NC | Urology Physician (208800000X) |
United | 80081 | $82.35 | 1366428401 - AARON ASKEW | 931224010 - PRAXIS HEALTH, P.C. | OR | Orthopaedic Trauma Physician (207XX0801X) |
United | 80081 | $74.86 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 80081 | $40.79 | 1366400376 - SUNRISE HOME HEALTH CARE INC. | 650307774 - (FL) SUNRISE HOME HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 80081 | $84.83 | 1053744888 - ASHLEY O'CONNOR | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Pediatric Nurse Practitioner (363LP0200X) |
United | 80081 | $111.19 | 1295952380 - OVERLOOK HOSPITAL, ATLANTIC HEALTH SYSTEMS | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | 80081 | $75.73 | 1033117007 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 80081 | $31.44 | 1053866707 - BRITTANY PTACHICK | 541958039 - HROA 401K PLAN | VA | Family Nurse Practitioner (363LF0000X) |
United | 80081 | $40.42 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 80081 vs. Other Pathology and Laboratory Procedures Codes
The CPT 80081 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 80081 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 |
|---|---|---|
| 80055-CPT | Low | Obstetric Panel, Obstetric Panel This Panel Must Include The Following Blood Count Complete Cbc Automated And Automated Differential Wbc Count 85025 Or 85027 And 85004 Or Blood Count Complete Cbc Automated 85027 And Appropriate Manual Differential Wbc Count 85007 Or 85009 Hepatitis B Surface Antigen Hbsag 87340 Antibody Rubella 86762 Syphilis Test Non Treponemal Antibody Qualitative Eg Vdrl Rpr Art 86592 Antibody Screen Rbc Each Serum Technique 86850 Blood Typing Abo 86900 And Blood Typing Rh D 86901 |
| 80081-CPT | Low | Obstetric Panel, Obstetric Panel Includes Hiv Testing This Panel Must Include The Following Blood Count Complete Cbc And Automated Differential Wbc Count 85025 Or 85027 And 85004 Or Blood Count Complete Cbc Automated 85027 And Appropriate Manual Differential Wbc Count 85007 Or 85009 Hepatitis B Surface Antigen Hbsag 87340 Hiv 1 Antigen S With Hiv 1 And Hiv 2 Antibodies Single Result 87389 Antibody Rubella 86762 Syphilis Test Non Treponemal Antibody Qualitative Eg Vdrl Rpr Art 86592 Antibody Screen Rbc Each Serum Technique 86850 Blood Typing Abo 86900 And Blood Typing Rh D 86901 |
| 86592-CPT | Low | Syphilis Testing, This Test Detects Antibodies To Syphilis A Bacterial Infection. It Is Frequently Spread By Sexual Contact. Blood Tests Screen For The Infection And Monitor Response To Treatment. |
| 86762-CPT | Low | German Measles Test, The Test Detects Antibodies To The Rubella Virus That Causes German Measles. A Positive Test Indicates Either A Current Infection Or Immunity From A Vaccine. The Test Is Used To Evaluate Immune Status. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80081. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80081 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 80081) and we'll show you how you compare in 15 minutes or less.