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 80305 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.
Drug Test Prsmv Dir Opt Obs, Drug Test S Presumptive Any Number Of Drug Classes Any Number Of Devices Or Procedures Capable Of Being Read By Direct Optical Observation Only Eg Utilizing Immunoassay Eg Dipsticks Cups Cards Or Cartridges Includes Sample Validation When Performed Per Date Of Service
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Therapeutic Drug Assays |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | QW - CLIA Waived Tests 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $12.60 national lab fee schedule rate (2026) · View Medicare rates for 80305 |
| Medicaid Fee Schedule | $11.89 median of the 8 states in the free preview · View Medicaid rates for 80305 |
National average reimbursement for CPT 80305 by major payers:
$10.90
$8.11
$13.74
$35.63
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 80305.
CPT 80305
5 of 25 sample ratesHigher to lower in this preview
Huy Do
Kelsey-Seybold Medical Group PLLC
$14.92Published rateLani Ackerman
Family Health Specialists PLLC
$6.28Published rateErnesto Malave Md PA
$6.28Published rateAurora Mustafa Alvarez
Mar Slz LLC
$5.28Published rateKevin Comfort
$5.28Published 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 80305 vs. Other Therapeutic Drug Assays Codes
The CPT 80305 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 80305 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 |
|---|---|---|
| 80285-CPT | Low | Voriconazole, A Lab Test For Voriconazole. This Drug Is Typically Used To Treat Fungal Infections. |
| 80305-CPT | Low | Drug Test Prsmv Dir Opt Obs, Drug Test S Presumptive Any Number Of Drug Classes Any Number Of Devices Or Procedures Capable Of Being Read By Direct Optical Observation Only Eg Utilizing Immunoassay Eg Dipsticks Cups Cards Or Cartridges Includes Sample Validation When Performed Per Date Of Service |
| 80306-CPT | Low | Drug Test(S) Presumptive Any Number Of Drug Classes Any Number Of Devices Or Procedures; Read By Instrument Assisted Direct Optical Observation (Eg Utilizing Immunoassay [Eg Dipsticks Cups Cards Or Cartridges]) Includes Sample Validation When Performed Per Date Of Service (Desc Revised 1/1/2018) |
| 80307-CPT | Low | Drug Test Prsmv Chem Anlyzr, Drug Test S Presumptive Any Number Of Drug Classes Any Number Of Devices Or Procedures By Instrument Chemistry Analyzers Eg Utilizing Immunoassay Eg Eia Elisa Emit Fpia Ia Kims Ria Chromatography Eg Gc Hplc And Mass Spectrometry Either With Or Without Chromatography Eg Dart Desi Gc Ms Gc Ms Ms Lc Ms Lc Ms Ms Ldtd Maldi Tof Includes Sample Validation When Performed Per Date Of Service |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80305. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80305 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 80305) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
CPT (Current Procedural Terminology) codes are a standardized set of five-digit alphanumeric codes used by medical professionals to report medical, surgical, and diagnostic procedures and services to entities like physicians, patients, and accreditation organizations. They are maintained by the American Medical Association (AMA).
The cost of medical procedures and services can vary significantly based on factors such as location, specific healthcare provider, and your insurance plan. To get an estimate for a specific CPT code and your geographic location, you can utilize tools like Payerprice's fee schedule lookup tool. This tool allows you to search with a CPT code and specific location to find relevant cost information, helping you understand potential expenses.
No, CPT codes are primarily for reporting medical procedures and services. Other coding systems are also used in medical billing. These include HCPCS Level II codes (Healthcare Common Procedure Coding System), which cover services, supplies, drugs, and durable medical equipment not included in CPT, and ICD-10 codes (International Classification of Diseases, 10th Revision), which are used to describe diagnoses and reasons for a patient's visit.
Insurance coverage for services associated with a CPT code depends on your specific insurance plan, the medical necessity of the procedure, and your policy's terms regarding deductibles, co-pays, and co-insurance. It's crucial to contact your insurance provider directly to understand your benefits and coverage for a particular procedure or service. You can also use resources like Payerprice to compare costs and potentially understand your out-of-pocket responsibilities better.
Transparent pricing for healthcare services is becoming more accessible. For detailed fee schedule information linked to CPT codes and specific locations, Payerprice offers a lookup tool that can assist you in researching costs before receiving care. This can help you make more informed decisions about your healthcare choices and understand potential financial obligations.