Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 80193 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.
Leflunomide Monitoring, This Test Measures The Therapeutic Level Of Leflunomide A Drug That Is Used To Treat Rheumatoid Arthritis In Adults.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Therapeutic Drug Assays |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | 90 - Reference Laboratory PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $38.57 national lab fee schedule rate (2026) · View Medicare rates for 80193 |
| Medicaid Fee Schedule | $35.485 median of the 8 states in the free preview · View Medicaid rates for 80193 |
National average reimbursement for CPT 80193 by major payers:
$30.79
$23.08
$38.57
$74.45
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 80193.
CPT 80193
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$84.85Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$38.57Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$23.14Published rateAnant Desai
Renal Consultants Medical Group
$16.20Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$13.50Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 80193 vs. Other Therapeutic Drug Assays Codes
The CPT 80193 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 80193 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 |
|---|---|---|
| 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. |
| 80189-CPT | Low | Itraconazole Monitoring, This Test Measures The Therapeutic Level Of Itraconazole A Drug That Is Typically Used To Treat A Fungal Infection. |
| 80190-CPT | Low | Heart Medication Assessment, Both Procainamide And Quinidine Are Used To Treat Life-Threatening Heart Conditions. Periodic Assessment Monitors Potential Side Effects Ensures The Lowest Therapeutic Dose And Evaluates Treatment Effectiveness. |
| 80193-CPT | Low | Leflunomide Monitoring, This Test Measures The Therapeutic Level Of Leflunomide A Drug That Is Used To Treat Rheumatoid Arthritis In Adults. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80193. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80193 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 80193) and we'll show you how you compare in 15 minutes or less.