CPT 80183 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 | Therapeutic Drug Assays Pathology and Laboratory Procedures |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80183 |
National average reimbursement for CPT 80183 by major payers:
$11.73
$9.60
$14.82
$41.23
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 80183 | $32.63 | 1154328896 - KELLEY PARNELL | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Neurology Physician (2084N0400X) |
United | 80183 | $13.25 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 80183 | $18.09 | 1922058569 - SAN ANTONIO VAMC | 742112082 | TX | General Acute Care Hospital (282N00000X) |
United | 80183 | $13.25 | 1134172406 - COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP, MEDICAL CITY ARLINGTON | 621682201 - COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 80183 | $32.63 | 1447293188 - RANDALL JOHNSON | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Neurological Surgery Physician (207T00000X) |
United | 80183 | $11.93 | 1407301211 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH OB/GYN CLINIC | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 80183 | $11.93 | 1821544925 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-SENECA | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 80183 | $13.25 | 1447723945 - MEDICAL UNIVERSITY HOSPITAL AUTHORITY, MUSC HEALTH MARION MEDICAL CENTER | 571098556 - (SC) MEDICAL UNIVERSITY HOSPITAL AUTHORITY | SC | General Acute Care Hospital (282N00000X) |
United | 80183 | $11.93 | 1629432869 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH OP SURGERY SPARTANBURG | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 80183 | $13.25 | 1598766495 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER,INC | 720423635 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | 80183 | $13.25 | 1528026267 - LONGVIEW MEDICAL CENTER LP, LONGVIEW REGIONAL MEDICAL CENTER | 621762420 | TX | General Acute Care Hospital (282N00000X) |
United | 80183 | $29.15 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 80183 | $7.59 | 1003192311 - EL CAMPO MEMORIAL HOSPITAL | 452750258 - (TX) EL CAMPO MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 80183 | $32.63 | 1669627220 - KIM HERMANS | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Occupational Therapist (225X00000X) |
United | 80183 | $13.25 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
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 80183 vs. Other Pathology and Laboratory Procedures Codes
The CPT 80183 code is part of the Therapeutic Drug Assays 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 80183 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 |
|---|---|---|
| 80179-CPT | Low | Aspirin Therapy Monitoring, This Test Measures The Therapeutic Level Of Aspirin (A Class Of Nonsteroidal Anti-Inflammatory Drugs (Nsaids)). Blood Concentration Levels May Be Monitored When Aspirin Is Taken Long-Term For Therapy Or If Overdose Is Suspected. |
| 80181-CPT | Low | Flecainide Monitoring, This Test Measures The Therapeutic Level Of Flecainide Present In Blood And Urine Samples. Flecainide Is Typically Used To Prevent And Treat Abnormally Fast Heart Rates. |
| 80183-CPT | Low | Medication Monitoring, Oxcarbazepine Typically Is Used To Treat Seizures Caused By Epilepsy. Periodic Monitoring Evaluates Dosage Adverse Effects And Interactions With Other Drugs. |
| 80187-CPT | Low | Posaconazole, A Lab Test For Posaconazole. This Drug Is Typically Used To Treat Or Prevent Fungal Infections. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80183. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80183 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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