Data Platform
Sign InTry for Free

CPT 80202 Fee Schedule

Last Verified: December 2025

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.

Vancomycin
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Therapeutic Drug Assays

Common Place of Service

21 - Inpatient Hospital

81 - Independent Laboratory

Common Modifiers

None

26 - Professional component

90 - Reference Laboratory

Complexity LevelLow

National average reimbursement for CPT 80202 by major payers:

bcbs

$11.75

uhc

$17.42

aetna

$15.86

cigna

$20.18

Preview provider-level rates for...
For billing codeCPT 80202
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 80202

United
80202$7.941144227935 - CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE, TRINITY MEDICAL720578642 - (LA) RIVERLAND MEDICAL CENTERLACritical Access Hospital (282NC0060X)
United
80202$7.941447259627 - TYLER COUNTY HOSPITAL DISTRICT746067306TXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531972709970 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE EAST CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531396520862 - LAKE SURGICAL HOSPITAL SLIDELL, LLC474228147 - (LA) LAKE SURGICAL HOSPITAL SLIDELL, LLC DBA SOUTHERN SURGICAL HOSPITALLAGeneral Acute Care Hospital (282N00000X)
United
80202$8.311689655912 - NOCONA HOSPITAL DISTRICT, NOCONA GENERAL HOSPITAL751368648TXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531306897277 - COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP, MEDICAL CITY DENTON621682213 - (TX) COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LPTXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531932204427 - NMC OPERATING COMPANY LLC, THE SPINE HOSPITAL OF LOUISIANA270059959 - (LA) NMC OPERATING COMPANY, LLCLAGeneral Acute Care Hospital (282N00000X)
United
80202$11.351609135904 - ANDREW CORONA273026151 - (TX) MID COAST MEDICAL CENTER-CENTRALTXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531831975572 - DECATUR HEALTH SERVICES, LLC932081386TXGeneral Acute Care Hospital (282N00000X)
United
80202$7.751407191984 - BSA HOSPITAL LLC900914340TXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR621619857TXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
80202$12.181942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY741282696 - ST JOSEPH REGIONAL HEALTH CENTERTXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531700801909 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS954537720TXGeneral Acute Care Hospital (282N00000X)
United
80202$16.251609971019 - SCURRY COUNTY HOSPITAL DISTRICT, COGDELL MEMORIAL HOSPITAL752403687 - (TX) SCURRY COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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 80202 vs. Other Therapeutic Drug Assays Codes

The CPT 80202 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 80202 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.

CodeComplexityDescription
80184-CPTLowPhenobarbital
80188-CPTLowPrimidone
80192-CPTLowProcainamide W/Metabolites
80202-CPTLowVancomycin

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80202. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 80202 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 80202) and we'll show you how you compare in 15 minutes or less.