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See a sample rate comparisonCPT 80306 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(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)
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Therapeutic Drug Assays |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | 26 - Professional component QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | $17.14 national lab fee schedule rate (2026) · View Medicare rates for 80306 |
| Medicaid Fee Schedule | $16.02 median of the 8 states in the free preview · View Medicaid rates for 80306 |
National average reimbursement for CPT 80306 by major payers:
$14.13
$10.89
$17.45
$39.24
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CPT 80306
5 of 25 sample ratesHigher to lower in this preview
Scott & White Memorial Hospital, Baylor Scott & White Medical Center - Temple
Scott & White Clinic
$32.99Published rateMethodist Hospitals Of Dallas, Methodist Charlton Medical Center
Methodist Hospitals Of Dallas
$17.13Published ratePalo Pinto County Hospital District, Palo Pinto General Hospital
$11.97Published rateDallas County Hospital District, Parkland Health
Dallas County Hospital District
$8.38Published rateDonna Medical Clonic
Donna Medical Clinic, P.A.
$7.19Published rate
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See a sample payer proposalCPT 80306 vs. Other Therapeutic Drug Assays Codes
The CPT 80306 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 80306 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 |
|---|---|---|
| 80299-CPT | Low | Medication Therapy Monitoring, This Analysis Is Performed To Determine The Correct Dose Of A Therapeutic Drug Or To Monitor A Drug For Potential Adverse Effects. |
| 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 80306. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80306 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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