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CPT 80202 Fee Schedule

Last Verified: February 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.

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
Medicare Fee ScheduleView Medicare rates for 80202

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$13.531174576698 - CHCA BAYSHORE LP, BAYSHORE MEDICAL CENTER621801359TXGeneral Acute Care Hospital (282N00000X)
United
80202$16.251689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL752313255TXGeneral Acute Care Hospital (282N00000X)
United
80202$19.781801825005 - HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH, LASALLE GENERAL HOSPITAL720690217 - (LA) HOSPITAL SERVICE DISTRICT 2 OF LASALLE PARISHLAGeneral Acute Care Hospital (282N00000X)
United
80202$7.761093783391 - CHRISTUS SPOHN HEALTH SYSTEM CORPORATION, CHRISTUS SPOHN HOSPITAL KLEBERG760422435 - C H WILKINSON PHYSICIAN NETWORKTXGeneral 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$7.941699768705 - GONZALES HEALTHCARE SYSTEMS741625013TXGeneral Acute Care Hospital (282N00000X)
United
80202$7.011295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM752796815 - CHRISTUS HEALTH ARK-LA-TEXTXGeneral Acute Care Hospital (282N00000X)
United
80202$7.941972590602 - PALO PINTO COUNTY HOSPITAL DISTRICT, PALO PINTO GENERAL HOSPITAL751256948TXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531689628984 - COLUMBIA HOSPITAL AT MEDICAL CITY DALLAS SUBSIDIARY LP, MEDICAL CITY DALLAS621682198TXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531871911016 - NORTH TEXAS, MEDICAL CITY ALLIANCE464027347 - (TX) NORTH TEXASTXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531295723229 - ST FRANCIS MEDICAL CENTER, INC720408970 - (LA) ST FRANCIS MEDICAL CENTER INCLAGeneral Acute Care Hospital (282N00000X)
United
80202$11.351871599829 - WILSON COUNTY MEMORIAL HOSPITAL DISTRICT742019736 - (TX) WILSON COUNTY MEMORIAL HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
80202$13.531669732178 - AD HOSPITAL EAST, LLC475587037TXGeneral Acute Care Hospital (282N00000X)
United
80202$12.181104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C.LAGeneral Acute Care Hospital (282N00000X)
United
80202$13.531740273994 - ECTOR COUNTY HOSPITAL DISTRICT, MEDICAL CENTER HOSPITAL752302928TXGeneral 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

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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.

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