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See a sample rate comparisonHealthcare 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 | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80326 |
| Medicaid Fee Schedule | $14.79 median of the 6 states in the free preview · View Medicaid rates for 80326 |
National average reimbursement for CPT 80326 by major payers:

$15.65

$23.89

$1.13

$59.81
Choose a payer to see a sample of rates for CPT 80326.
Citizens Medical Center County Of Victoria, County Of Victoria Citizens Medical Center
Macon Northside Hospital, LLC, Piedmont Macon North Hospital
Macon Northside Hospital LLC
Macon Northside Hospital, LLC, Piedmont Macon North Hospital
Macon Northside Hospital LLC
West Carroll Health Systems LLC, West Carroll Memorial Hospital
West Carroll Health Systems L.L.C.
Tyler County Hospital District
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 80326 vs. Other Therapeutic Drug Assays Codes
The CPT 80326 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 80326 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 |
|---|---|---|
| 80323-CPT | Low | Alkaloid Test, The Alkaloid Test Measures The Presence Of Alkaloids Which Are In Certain Types Of Drugs. Examples Include Morphine Strychnine And Quinine. |
| 80324-CPT | Low | Amphetamine Drug Screening, This Screening Measures The Amount Of Amphetamine Or Methamphetamine Present In A Blood Or Urine Sample. |
| 80325-CPT | Low | Amphetamine Drug Screening, This Screening Measures The Amount Of Amphetamine Or Methamphetamine Present In A Blood Or Urine Sample. |
| 80326-CPT | Low | Amphetamine Drug Screening, This Screening Measures The Amount Of Amphetamine Or Methamphetamine Present In A Blood Or Urine Sample. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80326. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80326 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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