CPT 80372 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | Therapeutic Drug Assays Pathology and Laboratory Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory Q4 - Service for ordering / referring physician qualifies as a service exemption for laboratory services |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80372 |
National average reimbursement for CPT 80372 by major payers:

$22.62

$14.43

$2.04

$45.45
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 80372 | $29.86 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 80372 | $34.87 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 80372 | $14.51 | 1679578439 - MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER, CHRISTUS MOTHER FRANCES HOSPITAL TYLER | 750818167 - (TX) MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 80372 | $17.45 | 1134127301 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 80372 | $29.86 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 80372 | $22.85 | 1548588841 - HARLINGEN VAMC | 272466786 | TX | General Acute Care Hospital (282N00000X) |
United | 80372 | $63.36 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 80372 | $10.36 | 1407191984 - BSA HOSPITAL LLC | 900914340 | TX | General Acute Care Hospital (282N00000X) |
United | 80372 | $10.15 | 1942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY | 741282696 - ST JOSEPH REGIONAL HEALTH CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 80372 | $38.74 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 80372 | $13.88 | 1407996564 - AUSENCIO NUNEZ | 363950044 - PROGRESSIVE MEDICAL CENTER, S.C. | IL | Internal Medicine Physician (207R00000X) |
United | 80372 | $63.36 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 80372 | $36.27 | 1003166612 - MATTHEW LILLEY | 680637976 - BEND MEMORIAL CLINIC, PC | OR | Orthopaedic Surgery Physician (207X00000X) |
United | 80372 | $15.85 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 80372 | $34.87 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 80372 vs. Other Pathology and Laboratory Procedures Codes
The CPT 80372 code is part of the Therapeutic Drug Assays services used for Pathology and Laboratory Procedures. 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 80372 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 |
|---|---|---|
| 80345-CPT | Low | Barbiturate Drug Screening, This Test Measures The Amount Of Barbiturates Present In Blood And Urine Samples. Barbiturates Work On The Central Nervous System And Have Been Used As Sleeping Pills. |
| 80348-CPT | Low | Buprenorphine Drug Screening, This Test Measures The Amount Of Buprenorphine Present In Blood And Urine Samples. |
| 80353-CPT | Low | Cocaine Drug Screening, The Test Measures The Amount Of Cocaine In A Blood Or Urine Sample. |
| 80372-CPT | Low | Tapentadol Drug Screening, This Test Measures The Amount Of Tapentadol 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 80372. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80372 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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