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See a sample rate comparisonCPT 83080 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.
Tay-Sachs (Enzyme) Test, Test For A Rare Genetic Enzyme (Hexosaminidase) Deficiency That Prevents Breakdown Of Fatty Acids. Fats Are Stored In The Brain And Nerves Progressively Damaging The Central Nervous System.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Chemistry Procedures |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $16.87 national lab fee schedule rate (2026) · View Medicare rates for 83080 |
| Medicaid Fee Schedule | $16.66 median of the 8 states in the free preview · View Medicaid rates for 83080 |
National average reimbursement for CPT 83080 by major payers:
$14.93
$11.87
$18.21
$24.77
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CPT 83080
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$40.00Published rateChristopher Raio
St Francis Hospital
$22.27Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$16.87Published ratePrisma Health-Upstate
Prisma Health - Upstate
$15.18Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$9.11Published rate
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See a sample payer proposalCPT 83080 vs. Other Chemistry Procedures Codes
The CPT 83080 code is part of the Pathology and Laboratory Procedures services used for Chemistry 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 83080 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 |
|---|---|---|
| 83051-CPT | Low | Plasma Test For Hemoglobin, This Test Helps To Diagnose Conditions That Affect The Health Of Hemoglobin. Hemoglobin Enables Blood To Transport Oxygen. |
| 83060-CPT | Low | Reduced Blood Oxygen Test, The Test Examines A Blood Sample For Sulfhemoglobin. This Is A Substance Created By The Blood In Response To Certain Medicines. Sulfhemoglobin Makes Red Blood Cells Unable To Carry Oxygen And Can Result In Bluish-Colored Skin. |
| 83065-CPT | Low | Test For Unstable Hemoglobin, This Blood Test Evaluates The Sample For Hemoglobin That Breaks Down Too Quickly. The Condition Can Produce Symptoms Similar To Anemia. Unstable Hemoglobin May Also Be Produced During An Infection. |
| 83080-CPT | Low | Tay-Sachs (Enzyme) Test, Test For A Rare Genetic Enzyme (Hexosaminidase) Deficiency That Prevents Breakdown Of Fatty Acids. Fats Are Stored In The Brain And Nerves Progressively Damaging The Central Nervous System. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 83080. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 83080 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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