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See a sample rate comparisonCPT 80355 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.
Gabapentin Drug Screening, This Test Measures The Amount Of Gabapentin Present In Blood And Urine Samples.
| 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 TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80355 |
| Medicaid Fee Schedule | $16.48 median of the 5 states in the free preview · View Medicaid rates for 80355 |
National average reimbursement for CPT 80355 by major payers:
$20.48
$13.58
$1.99
$48.27
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CPT 80355
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$63.36Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$17.45Published rateKevin Schlessel
Columbus Arthritis Center
$10.66Published rateSacred Heart Health System Inc, Sacred Heart Home Care
Sacred Heart Health System Inc
$9.93Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$8.52Published rate
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See a sample payer proposalCPT 80355 vs. Other Therapeutic Drug Assays Codes
The CPT 80355 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 80355 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 |
|---|---|---|
| 80346-CPT | Low | Sedative Therapy Monitoring, Benzodiazepines Are A Class Of Sedatives That Can Have Strong Effects. A Blood Analysis Helps To Determine A Therapeutic Dose And Can Show Other Issues Such As Overdosing. |
| 80347-CPT | Low | Sedative Therapy Monitoring, Benzodiazepines Are A Class Of Sedatives That Can Have Strong Effects. A Blood Analysis Helps To Determine A Therapeutic Dose And Can Show Other Issues Such As Overdosing. |
| 80350-CPT | Low | Cannabinoid Drug Screening, This Test Measures The Amount Of Cannabinoids Present In Blood And Urine Samples. |
| 80355-CPT | Low | Gabapentin Drug Screening, This Test Measures The Amount Of Gabapentin Present In Blood And Urine Samples. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80355. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80355 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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