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See a sample rate comparisonCPT 80420 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.
Test For Cushings Syndrome, The Dexamethasone Suppression Test Is An Evaluation For Cushings Syndrome In Which The Adrenal Glands Make Too Much Cortisol. Two Blood Samples Are Taken To Compare: One Before A Dose Of Dexamethasone And Another The Next Morning.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Evocative/Suppression Testing Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $161.88 national lab fee schedule rate (2026) · View Medicare rates for 80420 |
| Medicaid Fee Schedule | $148.93 median of the 8 states in the free preview · View Medicaid rates for 80420 |
National average reimbursement for CPT 80420 by major payers:
$114.48
$81.10
$137.78
$221.94
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CPT 80420
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
Samaritan Emergency Medical Services PC
$213.68Published rateChca Bayshore Lp, Bayshore Medical Center
$161.88Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$98.73Published rateBaycare Home Care, Inc., Dba Sarasota Memorial Home Care
Baycare Home Care Inc
$72.87Published rateChristus Spohn Health System Corporation, Christus Spohn Hospital Kleberg
C H Wilkinson Physician Network
$41.27Published rate
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See a sample payer proposalCPT 80420 vs. Other Evocative/Suppression Testing Procedures Codes
The CPT 80420 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 80420 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 |
|---|---|---|
| 80420-CPT | Low | Test For Cushings Syndrome, The Dexamethasone Suppression Test Is An Evaluation For Cushings Syndrome In Which The Adrenal Glands Make Too Much Cortisol. Two Blood Samples Are Taken To Compare: One Before A Dose Of Dexamethasone And Another The Next Morning. |
| 80422-CPT | Low | Glucagon Test Series, The Glucagon Tolerance Test Helps Diagnose Hypoglycemic And Insulin Conditions. A Two-Minute Glucagon Iv Injection Causes An Insulin Peak. Glucose And Insulin Levels Are Measured At Baseline And Timed Intervals. |
| 80424-CPT | Low | Test For Adrenal Gland Tumor, This Version Of The Glucagon Tolerance Test Helps Diagnose Pheochromocytoma An Adrenal Gland Tumor. Glucagon Is Injected Through An Iv Over Two Minutes. Adrenalin Noradrenalin And Metanephrine Levels Are Measured At Baseline And Timed Intervals. |
| 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 80420. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80420 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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