CPT 80306 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Pathology and Laboratory Procedures • Therapeutic Drug Assays |
| Common Place of Service | • 11 - Office • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80306 |
National average reimbursement for CPT 80306 by major payers:
$14.13
$10.89
$17.45
$38.49
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 80306 | ||||||
United | 80306 | $8.38 | 1457358103 - BELLVILLE HOSPITAL DISTRICT, BELLVILLE GENERAL HOSPITAL | 274005511 - BELLVILLE MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $8.38 | 1316931835 - WILBARGER COUNTY HOSPITAL DISTRICT, WILBARGER GENERAL HOSPITAL | 756047638 - (TX) WILBARGER GENERAL HOSPITAL EMPLOYEE BENEFIT PLAN | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $8.38 | 1689655912 - NOCONA HOSPITAL DISTRICT, NOCONA GENERAL HOSPITAL | 751368648 | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $8.38 | 1508199621 - SERGE LARTCHENKO M.D., PLLC | 270839735 - (TX) SERGE LARTCHENKO MD PLLC | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $17.13 | 1063466035 - CHCA CLEAR LAKE LP, HCA HOUSTON HEALTHCARE CLEAR LAKE | 621801360 | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $20.56 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $32.99 | 1477516466 - SCOTT & WHITE MEMORIAL HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE | 742958277 - SCOTT & WHITE CLINIC | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $14.23 | 1922104546 - KAREN ROUNDS CLEARY | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 80306 | $7.19 | 1649223645 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, ROUND ROCK MEDICAL CENTER | 743001674 - (TX) LONE STAR CIRCLE OF CARE | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $8.38 | 1932123247 - DALLAS COUNTY HOSPITAL DISTRICT, PARKLAND HEALTH | 756004221 - DALLAS COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $19.95 | 1932729803 - DALLAS VAMC | 756108647 | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $17.13 | 1275592131 - METHODIST HOSPITALS OF DALLAS, METHODIST CHARLTON MEDICAL CENTER | 750800661 - METHODIST HOSPITALS OF DALLAS | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $11.97 | 1972590602 - PALO PINTO COUNTY HOSPITAL DISTRICT, PALO PINTO GENERAL HOSPITAL | 751256948 | TX | General Acute Care Hospital (282N00000X) |
United | 80306 | $19.95 | 1801825005 - HOSPITAL SERVICE DISTRICT #2 OF LASALLE PARISH, LASALLE GENERAL HOSPITAL | 720690217 - (LA) HOSPITAL SERVICE DISTRICT 2 OF LASALLE PARISH | LA | General Acute Care Hospital (282N00000X) |
United | 80306 | $7.19 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 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 | Quantitation Of Therapeutic Drug Not Elsewhere Specified (Desc Revised 01/01/15) |
| 80305-CPT | Low | 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 (Desc Revised 1/1/2018) |
| 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(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 (Desc Revised 1/1/2018) |
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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