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See a sample rate comparisonCPT 80367 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.
Propoxyphene Drug Screening, This Test Measures The Amount Of Propoxyphene 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 21 - Inpatient Hospital |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80367 |
| Medicaid Fee Schedule | $15.35 median of the 5 states in the free preview · View Medicaid rates for 80367 |
National average reimbursement for CPT 80367 by major payers:
$24.86
$15.09
$2.14
$36.44
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CPT 80367
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$63.36Published rateAsya Segalene
Allergy & Asthma Of Dupage, S.C.
$26.02Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$17.45Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$10.31Published rateGraham Regional Medical Center, Graham General Hsopital Physicians
$10.15Published rate
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See a sample payer proposalCPT 80367 vs. Other Therapeutic Drug Assays Codes
The CPT 80367 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 80367 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. |
| 80365-CPT | Low | Oxycodone Drug Screening, This Test Measures The Amount Of Oxycodone Present In Blood And Urine Samples. |
| 80366-CPT | Low | Pregabalin Drug Screening, This Test Measures The Amount Of Pregabalin Present In Blood And Urine Samples. |
| 80367-CPT | Low | Propoxyphene Drug Screening, This Test Measures The Amount Of Propoxyphene 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 80367. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80367 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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