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See a sample rate comparisonCPT 80428 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.
Pituitary Gland Tests, Hgh Stimulation Is One Type Of Human Growth Hormone Test. It Helps To Diagnose Low Pituitary Gland Function. Insulin Or Arginine Is Given By Iv With Blood Samples Taken At Timed Intervals To See If The Pituitary Gland Produces Growth Hormone.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Evocative/Suppression Testing Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | 59 - Distinct Procedural Service 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | $66.70 national lab fee schedule rate (2026) · View Medicare rates for 80428 |
| Medicaid Fee Schedule | $61.365 median of the 8 states in the free preview · View Medicaid rates for 80428 |
National average reimbursement for CPT 80428 by major payers:
$58.31
$47.16
$72.83
$96.44
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CPT 80428
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$146.74Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$66.70Published rateOconee Medical Center
Prisma Health - Upstate
$60.02Published rateRestorative Health Rehabilitation Inc
$40.00Published 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
$23.35Published rate
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See a sample payer proposalCPT 80428 vs. Other Evocative/Suppression Testing Procedures Codes
The CPT 80428 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 80428 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 |
|---|---|---|
| 80418-CPT | Moderate | Pituitary Evaluation Panel, Combined Rapid Anterior Pituitary Evaluation Panel This Panel Must Include The Following: Adrenocorticotropic Hormone (Acth) (82024 X 4) Luteinizing Hormone (Lh) (83002 X 4) Follicle Stimulating Hormone (Fsh) (83001 X 4) Prolactin (84146 X 4) Human Growth Hormone (Hgh) (83003 X 4) Cortisol (82533 X 4) Thyroid Stimulating Hormone (Tsh) (84443 X 4) |
| 80426-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. |
| 80428-CPT | Low | Pituitary Gland Tests, Hgh Stimulation Is One Type Of Human Growth Hormone Test. It Helps To Diagnose Low Pituitary Gland Function. Insulin Or Arginine Is Given By Iv With Blood Samples Taken At Timed Intervals To See If The Pituitary Gland Produces Growth Hormone. |
| 80436-CPT | Low | Adrenal Insufficiency Test, This Adrenal Insufficiency Test Delivers A Dose Of Metyrapone To Stimulate Activity Along The Hypothalamus-Pituitary Gland-Adrenal Gland (Hpa) Axis. Cortisol And Other Stress Steroids Will Be Produced Based Upon How Well These Three Glands Work Together. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80428. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80428 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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