CPT 80414 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 | Evocative/Suppression Testing Procedures Pathology and Laboratory Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80414 |
National average reimbursement for CPT 80414 by major payers:
$44.69
$36.25
$60.69
$78.41
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 80414 | $51.63 | 1912948845 - PHYSICIANS SURGICAL HOSPITALS, LLC | 731620274 - (TX) PHYSICIANS SURGICAL HOSPITALS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 80414 | $61.35 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 80414 | $27.89 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 80414 | $55.00 | 1649599168 - RESTORATIVE HEALTH REHABILITATION INC | 272533824 - (FL) RESTORATIVE HEALTH REHABILITATION INC | FL | Home Health Agency (251E00000X) |
United | 80414 | $61.35 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 80414 | $30.71 | 1013212448 - GUSTAVO DELGADO | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 80414 | $30.98 | 1497944565 - MICHAEL SHULER | 581076549 - ATHENS ORTHOPEDIC CLINIC, P.A. | GA | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 80414 | $27.89 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 80414 | $108.44 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 80414 | $21.69 | 1073515912 - MARK VITAL | 760512625 - HEA CLINIC, P.A., DBA HOUSTON EYE ASSOCIATES | TX | Ophthalmology Physician (207W00000X) |
United | 80414 | $29.51 | 1891774519 - LEON HOME HEALTH, LLC, LEON AT HOME | 261288029 | FL | Home Health Agency (251E00000X) |
United | 80414 | $113.61 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 80414 | $68.16 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 80414 | $70.76 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 80414 | $36.08 | 1619910627 - BRADLEY WEISNER | 562107759 - UROLOGY SPECIALISTS OF THE CAROLINAS, PLLC | NC | Urology Physician (208800000X) |
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 80414 vs. Other Pathology and Laboratory Procedures Codes
The CPT 80414 code is part of the Evocative/Suppression Testing Procedures 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 80414 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 |
|---|---|---|
| 80402-CPT | Low | Adrenal Gland Enzyme Testing, A Variation Of The Acth Stimulation Panel This Test Checks Androgen As Well As Cortisol. The Goal Is To Verify The Presence Or Absence Of Specific Enzymes That Can Interfere With Normal Development Of Secondary Sexual Characteristics. |
| 80408-CPT | Low | Aldosterone Hormone Test, Aldosterone Works With Renin A Kidney Enzyme To Regulate Salt And Potassium Levels. Because Of This Renin Often Is Measured Along With Aldosterone. Testing Can Show Problems With The Heart Kidney Liver Or Adrenal Glands. |
| 80410-CPT | Low | Calcitonin Hormone Test, This Test Measures The Level Of Calcitonin In A Blood Sample. Calcitonin Is A Hormone That Helps Process Calcium And Phosphorus. |
| 80414-CPT | Low | Fertility Hormone Test, The Human Chorionic Gonadotropin (Hcg) Stimulation Test Helps To Determine Whether Reproductive Hormones Are Functioning Properly. Testosterone Estradiol Follicle Stimulating Hormone (Fsh) Or Luteinizing Hormone (Lh) Are Measured After An Injection Of Hcg. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80414. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80414 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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