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CPT 80331 Fee Schedule

Last Verified: January 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.

Definitive Drug Testing; Analgesics, Non-Opioid; 6 Or More
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Therapeutic Drug Assays

Common Place of Service

81 - Independent Laboratory

11 - Office

Common Modifiers

None

90 - Reference Laboratory

XU - Unusual Non-Overlapping Service

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 80331

National average reimbursement for CPT 80331 by major payers:

bcbs

$16.61

uhc

$20.16

aetna

$0.49

cigna

$59.63

Preview provider-level rates for...
For billing codeCPT 80331
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 80331

United
80331$8.151073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
80331$11.561134126659 - CALDWELL MEMORIAL HOSPITAL INC720878037 - (LA) CALDWELL MEMORIAL HOSPITAL, INC.LAGeneral Acute Care Hospital (282N00000X)
United
80331$24.791669480323 - KELL WEST REGIONAL HOSPITAL LLC752756307 - KELL WEST REGIONAL HOSPITAL, LLCTXGeneral Acute Care Hospital (282N00000X)
United
80331$24.791720589328 - PIEDMONT WALTON HOSPITAL INC824194264 - (GA) PIEDMONT WALTON HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
80331$16.521467442418 - NORTHWEST TEXAS HEALTHCARE SYSTEM INC, NORTHWEST TEXAS HEALTHCARE SYSTEM232238976TXGeneral Acute Care Hospital (282N00000X)
United
80331$24.791689676835 - NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT, NATCHITOCHES REGIONAL MEDICAL CENTER726013916 - (LA) NATCHITOCHES REGIONAL MEDICAL CENTERLAGeneral Acute Care Hospital (282N00000X)
United
80331$8.151073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
80331$24.791760498588 - PIEDMONT NEWTON HOSPITAL, INC., NEWTON MEDICAL CENTER582155150 - (GA) PIEDMONT NEWTON HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
80331$8.151073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
80331$8.151073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
80331$8.151073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
80331$16.521306843826 - WEST CARROLL HEALTH SYSTEMS LLC, WEST CARROLL MEMORIAL HOSPITAL562300247 - WEST CARROLL HEALTH SYSTEMS L.L.C.LAGeneral Acute Care Hospital (282N00000X)
United
80331$24.791225034333 - PIEDMONT HENRY HOSPITAL, INC.582200195 - (GA) PIEDMONT HENRY HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
80331$24.791225034333 - PIEDMONT HENRY HOSPITAL, INC.582200195 - (GA) PIEDMONT HENRY HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
80331$11.561851390967 - UHS OF TEXOMA, INC, TEXOMA MEDICAL CENTER205908627 - UHS OF TEXOMA INCTXGeneral 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 80331 vs. Other Therapeutic Drug Assays Codes

The CPT 80331 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 80331 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
80328-CPTLowDefinitive Drug Testing; Anabolic Steroids; 3 Or More
80329-CPTLowDefinitive Drug Testing; Analgesics, Non-Opioid; 1 Or 2
80330-CPTLowDefinitive Drug Testing; Analgesics, Non-Opioid; 3-5
80331-CPTLowDefinitive Drug Testing; Analgesics, Non-Opioid; 6 Or More

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80331. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 80331 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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