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See a sample rate comparisonHealthcare 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 | Pathology and Laboratory Procedures Evocative/Suppression Testing Procedures |
| Common Place of Service | 11 - Office |
| Complexity Level | Low |
| Medicare Fee Schedule | $209.32 national lab fee schedule rate (2026) · View Medicare rates for 80416 |
| Medicaid Fee Schedule | $196.285 median of the 8 states in the free preview · View Medicaid rates for 80416 |
National average reimbursement for CPT 80416 by major payers:

$156.92

$119.55

$191.17

$290.87
Choose a payer to see a sample of rates for CPT 80416.
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
Pelham Medical Center
Nicole Schwab
Allergy & Asthma Of Dupage, S.C.
Christopher Raio
Mercy Medical Center
Da Pediatric Rehabilitation
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See a sample payer proposalCPT 80416 vs. Other Evocative/Suppression Testing Procedures Codes
The CPT 80416 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 80416 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 |
|---|---|---|
| 80416-CPT | Low | Kidney Enzyme (Renin) Test, Renin Is An Enzyme Made By The Kidneys. A Stimulation Panel Tests Concerns About Adrenal Gland Function Or Blood Pressure. A Baseline Blood Sample Is Collected A Diuretic Or Blood Pressure Drug Given And Then A Series Of Samples Are Taken And Studied. |
| 80417-CPT | Low | Kidney Enzyme (Renin) Test, Renin Is An Enzyme Made By The Kidneys. A Stimulation Panel Tests Concerns About Adrenal Gland Function Or Blood Pressure. A Baseline Blood Sample Is Collected A Diuretic Or Blood Pressure Drug Given And Then A Series Of Samples Are Taken And Studied. |
| 81000-CPT | Low | Urine Analysis, Urine Test That Checks Ph And Looks For Substances Such As Blood Crystals Bile And White Blood Cells (Antibodies). These May Be Viewed Under A Microscope Or Detected With Dip Sticks Or Colorizing Tablets. A Computer Analysis May Be Done As Well. |
| 81050-CPT | Low | Urine Flow Study, Several Urine Collections Are Made Over A Given Period Such As 24 Hours. Both The Volume And Speed Are Measured Usually As Amount Per Second. The Results May Be Used As A Baseline For Other Tests Or Simply To Check A Persons Ability To Urinate. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80416. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80416 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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