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See a sample rate comparisonCPT 80176 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.
Lidocaine Dose Assessment, This Is A Blood Test To Measure The Amount Of Lidocaine Over Time. It Can Help Determine Correct Dose And Therapeutic Effectiveness.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Therapeutic Drug Assays |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $14.69 national lab fee schedule rate (2026) · View Medicare rates for 80176 |
| Medicaid Fee Schedule | $14.505 median of the 8 states in the free preview · View Medicaid rates for 80176 |
National average reimbursement for CPT 80176 by major payers:
$12.91
$10.65
$15.57
$21.39
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CPT 80176
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$55.00Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$14.69Published rateGreenville Health System, Ghs Patewood Memorial Hospital
Prisma Health - Upstate
$13.22Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$11.77Published rateMark Vital
Hea Clinic, P.A., Dba Houston Eye Associates
$6.17Published rate
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See a sample payer proposalCPT 80176 vs. Other Therapeutic Drug Assays Codes
The CPT 80176 code is part of the Pathology and Laboratory Procedures services used for Therapeutic Drug Assays. 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 80176 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 |
|---|---|---|
| 80168-CPT | Low | Seizure Medication Monitoring, Lab Blood Test To Ensure Therapeutic Dosing Of Anticonvulsant Drug. Periodic Monitoring Evaluates Dosage Adverse Effects And Interactions With Other Drugs. |
| 80170-CPT | Low | Antibiotic Monitoring, Lab Blood Test To Ensure Therapeutic Levels Of An Antibiotic. Monitoring Ensures Levels Are High Enough To Treat The Infection But Low Enough To Avoid Toxicity. |
| 80173-CPT | Low | Haloperidol Drug Level, Haloperidol Is An Antipsychotic Used To Treat Severe Conditions Such As Schizophrenia And Delirium. Levels Are Monitored To Determine Correct Therapy Dose As Well As To Ensure It Is Not Interfering With Any Other Drug Therapies Being Used. |
| 80176-CPT | Low | Lidocaine Dose Assessment, This Is A Blood Test To Measure The Amount Of Lidocaine Over Time. It Can Help Determine Correct Dose And Therapeutic Effectiveness. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80176. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80176 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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