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See a sample rate comparisonCPT 80365 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.
Oxycodone Drug Screening, This Test Measures The Amount Of Oxycodone 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 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80365 |
| Medicaid Fee Schedule | $22.05 median of the 5 states in the free preview · View Medicaid rates for 80365 |
National average reimbursement for CPT 80365 by major payers:
$23.35
$15.59
$2.14
$53.24
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CPT 80365
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$63.36Published rateAndrew Corona
$24.05Published rateKevin Schlessel
Columbus Arthritis Center
$15.78Published rateLeon Home Health, LLC, Leon At Home
$11.17Published rateSt. Davids Healthcare Partnership, L.P., LLP, Heart Hospital Of Austin
Lone Star Circle Of Care
$10.15Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 80365 vs. Other Therapeutic Drug Assays Codes
The CPT 80365 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 80365 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 |
|---|---|---|
| 80354-CPT | Low | Fentanyl Drug Screening, This Test Measures The Amount Of Fentanyl Present In Blood And Urine Samples. |
| 80357-CPT | Low | Ketamine Drug Screening, This Test Measures The Amount Of Ketamine Present In Blood And Urine Samples. |
| 80358-CPT | Low | Methadone Drug Screening, The Test Measures A Urine Sample For The Amount Of Methadone Or Dimethadione Present. This Is Done To Assess Possible Toxicity And To Monitor Treatment. |
| 80365-CPT | Low | Oxycodone Drug Screening, This Test Measures The Amount Of Oxycodone 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 80365. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80365 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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