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See a sample rate comparisonCPT 80415 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Evocative/Suppression Testing Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $55.89 national lab fee schedule rate (2026) · View Medicare rates for 80415 |
| Medicaid Fee Schedule | $55.19 median of the 8 states in the free preview · View Medicaid rates for 80415 |
National average reimbursement for CPT 80415 by major payers:
$47.77
$39.22
$58.93
$80.85
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CPT 80415
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$122.96Published rateChristopher Raio
St Francis Hospital
$66.40Published rateTenet Hospitals Limited, The Hospitals Of Providence East Campus
$55.88Published rateBruce Madsen
Bridgeport Eye Physicians LLC
$33.61Published 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
$19.55Published rate
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See a sample payer proposalCPT 80415 vs. Other Evocative/Suppression Testing Procedures Codes
The CPT 80415 code is part of the Pathology and Laboratory Procedures services used for Evocative/Suppression Testing 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 80415 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 |
|---|---|---|
| 80406-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. |
| 80412-CPT | Moderate | Hormone Stimulation Test, Corticotropin-Releasing Hormone (Crh) Signals The Pituitary Gland To Release The Hormone Acth. This Tells The Adrenal Glands To Produce Cortisol. The Stimulation Test Measures How Well This Process Works. |
| 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. |
| 80415-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 80415. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80415 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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