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2018 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2018 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).

HCPCS RATE2018 SHORTDESC0001M 144.38 Infectious dis hcv 6 assays0001U 0.00 Rbc dna hea 35 ag 11 bld grp0002M 1006.80 Liver dis 10 assays w/ash0002U 0.00 Onc clrct 3 ur metab alg plp0003M 1006.80 Liver dis 10 assays w/nash0003U 1900.00 Onc ovar 5 prtn ser alg scor0004M 0.00 Scoliosis dna alys0005U 1520.00 Onco prst8 3 gene ur alg0006M 0.00 Onc hep gene risk classifier0006U 493.84 Rx mntr 120+ drugs & sbsts0007M 0.00 Onc gastro 51 gene nomogram0007U 228.86 Rx test prsmv ur w/def conf0008U 1195.82 Hpylori detcj abx rstnc dna0009M 0.00 Fetal aneuploidy trisom risk0009U 0.00 Onc brst ca erbb2 amp/nonamp0010U 0.00 Nfct ds strn typ whl gen seq0011U 228.86 Rx mntr lc-ms/ms oral fluid0012U 0.00 Germln do gene reargmt detcj0013U 0.00 Onc sld org neo gene reargmt0014U 0.00 Hem hmtlmf neo gene reargmt0016U 404.84 Onc hmtlmf neo rna bcr/abl10017U 226.34 Onc hmtlmf neo jak2 mut dna36415 6.00 Routine venipuncture78267 22.12 Breath tst attain/anal c-1478268 188.82 Breath test analysis c-1480047 27.46 Metabolic panel ionized ca80047 27.46 Metabolic panel ionized ca80048 20.88 Metabolic panel total ca80048 20.88 Metabolic panel total ca80051 17.32 Electrolyte panel80051 17.32 Electrolyte panel80053 26.08 Comprehen metabolic panel80053 26.08 Comprehen metabolic panel80055 118.04 Obstetric panel80061 33.06 Lipid panel80061 33.06 Lipid panel80069 21.44 Renal function panel80069 21.44 Renal function panel80074 117.62 Acute hepatitis panel

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HCPCS RATE2018 SHORTDESC80076 20.18 Hepatic function panel80081 184.84 Obstetric panel80150 37.22 Assay of amikacin80155 77.14 Drug assay caffeine80156 35.96 Assay carbamazepine total80157 32.72 Assay carbamazepine free80158 44.56 Drug assay cyclosporine80159 45.66 Drug assay clozapine80162 32.78 Assay of digoxin total80163 32.78 Assay of digoxin free80164 33.44 Assay dipropylacetic acd tot80165 33.44 Dipropylacetic acid free80168 40.34 Assay of ethosuximide80169 33.92 Drug assay everolimus80170 40.44 Assay of gentamicin80171 43.34 Drug screen quant gabapentin80173 35.96 Assay of haloperidol80175 32.72 Drug screen quan lamotrigine80176 36.28 Assay of lidocaine80177 32.72 Drug scrn quan levetiracetam80178 16.32 Assay of lithium80178 16.32 Assay of lithium80180 44.56 Drug scrn quan mycophenolate80183 32.72 Drug scrn quant oxcarbazepin80184 30.60 Assay of phenobarbital80185 32.72 Assay of phenytoin total80186 33.98 Assay of phenytoin free80188 40.96 Assay of primidone80190 120.00 Assay of procainamide80192 41.36 Assay of procainamide80194 36.06 Assay of quinidine80195 33.92 Assay of sirolimus80197 33.92 Assay of tacrolimus80198 34.92 Assay of theophylline80199 54.22 Drug screen quant tiagabine80200 39.82 Assay of tobramycin80201 29.44 Assay of topiramate80202 33.44 Assay of vancomycin80203 32.72 Drug screen quant zonisamide80299 37.28 Quantitative assay drug80305 26.92 Drug test prsmv dir opt obs80305 26.92 Drug test prsmv dir opt obs80306 35.92 Drug test prsmv instrmnt

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HCPCS RATE2018 SHORTDESC80307 143.66 Drug test prsmv chem anlyzr80400 80.54 Acth stimulation panel80402 214.70 Acth stimulation panel80406 193.24 Acth stimulation panel80408 309.88 Aldosterone suppression eval80410 66.16 Calcitonin stimul panel80412 1603.24 Crh stimulation panel80414 127.50 Testosterone response80415 137.98 Estradiol response panel80416 418.64 Renin stimulation panel80417 108.62 Renin stimulation panel80418 1430.86 Pituitary evaluation panel80420 323.76 Dexamethasone panel80422 113.76 Glucagon tolerance panel80424 124.68 Glucagon tolerance panel80426 366.44 Gonadotropin hormone panel80428 164.70 Growth hormone panel80430 258.66 Growth hormone panel80432 333.58 Insulin suppression panel80434 570.06 Insulin tolerance panel80435 254.36 Insulin tolerance panel80436 225.10 Metyrapone panel80438 124.48 Trh stimulation panel80439 165.96 Trh stimulation panel81000 8.04 Urinalysis nonauto w/scope81001 7.84 Urinalysis auto w/scope81002 6.96 Urinalysis nonauto w/o scope81003 5.54 Urinalysis auto w/o scope81003 5.54 Urinalysis auto w/o scope81005 5.34 Urinalysis81007 59.96 Urine screen for bacteria81007 59.96 Urine screen for bacteria81015 7.52 Microscopic exam of urine81020 9.40 Urinalysis glass test81025 17.22 Urine pregnancy test81050 7.42 Urinalysis volume measure81105 301.78 Hpa-1 genotyping81106 301.78 Hpa-2 genotyping81107 301.78 Hpa-3 genotyping81108 301.78 Hpa-4 genotyping81109 301.78 Hpa-5 genotyping81110 301.78 Hpa-6 genotyping81111 301.78 Hpa-9 genotyping

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HCPCS RATE2018 SHORTDESC81112 301.78 Hpa-15 genotyping81120 386.50 Idh1 common variants81121 591.58 Idh2 common variants81161 558.00 Dmd dup/delet analysis81162 4505.86 Brca1&2 seq & full dup/del81170 600.00 Abl1 gene81175 1414.04 Asxl1 full gene sequence81176 597.28 Asxl1 gene target seq alys81200 94.50 Aspa gene81201 1560.00 Apc gene full sequence81202 560.00 Apc gene known fam variants81203 400.00 Apc gene dup/delet variants81205 189.98 Bckdhb gene81206 404.84 Bcr/abl1 gene major bp81207 357.62 Bcr/abl1 gene minor bp81208 429.24 Bcr/abl1 gene other bp81209 78.62 Blm gene81210 350.80 Braf gene81211 4791.68 Brca1&2 seq & com dup/del81212 880.00 Brca1&2 185&5385&6174 var81213 1106.00 Brca1&2 uncom dup/del var81214 2602.84 Brca1 full seq & com dup/del81215 750.50 Brca1 gene known fam variant81216 370.24 Brca2 gene full sequence81217 750.50 Brca2 gene known fam variant81218 597.28 Cebpa gene full sequence81219 300.32 Calr gene com variants81220 1113.20 Cftr gene com variants81221 194.44 Cftr gene known fam variants81222 870.14 Cftr gene dup/delet variants81223 998.00 Cftr gene full sequence81224 337.50 Cftr gene intron poly t81225 582.72 Cyp2c19 gene com variants81226 901.82 Cyp2d6 gene com variants81227 349.62 Cyp2c9 gene com variants81228 1800.00 Cytogen micrarray copy nmbr81229 2320.00 Cytogen m array copy no&snp81230 349.62 Cyp3a4 gene common variants81231 349.62 Cyp3a5 gene common variants81232 349.62 Dpyd gene common variants81235 649.16 Egfr gene com variants81238 1200.00 F9 full gene sequence81240 131.38 F2 gene

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HCPCS RATE2018 SHORTDESC81241 150.88 F5 gene81242 73.24 Fancc gene81243 114.08 Fmr1 gene detection81244 89.78 Fmr1 gene characterization81245 331.02 Flt3 gene81246 166.00 Flt3 gene analysis81247 349.62 G6pd gene alys cmn variant81248 750.50 G6pd known familial variant81249 1200.00 G6pd full gene sequence81250 116.98 G6pc gene81251 94.50 Gba gene81252 202.24 Gjb2 gene full sequence81253 123.04 Gjb2 gene known fam variants81254 70.00 Gjb6 gene com variants81255 102.90 Hexa gene81256 161.38 Hfe gene81257 204.52 Hba1/hba2 gene81258 750.50 Hba1/hba2 gene fam vrnt81259 1200.00 Hba1/hba2 full gene sequence81260 78.62 Ikbkap gene81261 488.86 Igh gene rearrange amp meth81262 137.10 Igh gene rearrang dir probe81263 727.20 Igh vari regional mutation81264 368.70 Igk rearrangeabn clonal pop81265 530.98 Str markers specimen anal81266 609.62 Str markers spec anal addl81267 512.24 Chimerism anal no cell selec81268 643.92 Chimerism anal w/cell select81269 404.80 Hba1/hba2 gene dup/del vrnts81270 226.34 Jak2 gene81272 659.02 Kit gene targeted seq analys81273 249.74 Kit gene analys d816 variant81275 386.50 Kras gene variants exon 281276 386.50 Kras gene addl variants81280 832.16 Long qt synd gene full seq81281 570.00 Long qt synd known fam var81282 2500.00 Long qt syn gene dup/dlt var81283 150.88 Ifnl3 gene81287 249.28 Mgmt gene methylation anal81288 384.64 Mlh1 gene81290 78.62 Mcoln1 gene81291 130.68 Mthfr gene81292 1350.80 Mlh1 gene full seq

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HCPCS RATE2018 SHORTDESC81293 662.00 Mlh1 gene known variants81294 404.80 Mlh1 gene dup/delete variant81295 763.40 Msh2 gene full seq81296 675.46 Msh2 gene known variants81297 426.60 Msh2 gene dup/delete variant81298 1283.70 Msh6 gene full seq81299 616.00 Msh6 gene known variants81300 476.00 Msh6 gene dup/delete variant81301 714.96 Microsatellite instability81302 1055.74 Mecp2 gene full seq81303 240.00 Mecp2 gene known variant81304 300.00 Mecp2 gene dup/delet variant81310 493.04 Npm1 gene81311 591.58 Nras gene variants exon 2&381313 510.10 Pca3/klk3 antigen81314 659.02 Pdgfra gene81315 511.88 Pml/raralpha com breakpoints81316 511.88 Pml/raralpha 1 breakpoint81317 1414.04 Pms2 gene full seq analysis81318 662.00 Pms2 known familial variants81319 407.00 Pms2 gene dup/delet variants81321 1200.00 Pten gene full sequence81322 105.70 Pten gene known fam variant81323 600.00 Pten gene dup/delet variant81324 1516.72 Pmp22 gene dup/delet81325 1539.16 Pmp22 gene full sequence81326 105.70 Pmp22 gene known fam variant81327 0.00 Sept9 methylation analysis81328 349.62 Slco1b1 gene com variants81330 94.00 Smpd1 gene common variants81331 102.14 Snrpn/ube3a gene81332 107.78 Serpina1 gene81334 659.02 Runx1 gene targeted seq alys81335 349.62 Tpmt gene com variants81340 515.84 Trb@ gene rearrange amplify81341 122.44 Trb@ gene rearrange dirprobe81342 497.52 Trg gene rearrangement anal81346 349.62 Tyms gene com variants81350 468.00 Ugt1a1 gene81355 176.40 Vkorc1 gene81361 349.62 Hbb gene com variants81362 750.50 Hbb gene known fam variant81363 404.80 Hbb gene dup/del variants

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HCPCS RATE2018 SHORTDESC81364 649.16 Hbb full gene sequence81370 992.90 Hla i & ii typing lr81371 809.04 Hla i & ii type verify lr81372 807.18 Hla i typing complete lr81373 274.96 Hla i typing 1 locus lr81374 179.62 Hla i typing 1 antigen lr81375 545.04 Hla ii typing ag equiv lr81376 301.78 Hla ii typing 1 locus lr81377 226.70 Hla ii type 1 ag equiv lr81378 853.26 Hla i & ii typing hr81379 828.10 Hla i typing complete hr81380 437.66 Hla i typing 1 locus hr81381 339.80 Hla i typing 1 allele hr81382 305.38 Hla ii typing 1 loc hr81383 269.46 Hla ii typing 1 allele hr81400 127.92 Mopath procedure level 181401 274.00 Mopath procedure level 281402 300.66 Mopath procedure level 381403 370.40 Mopath procedure level 481404 549.66 Mopath procedure level 581405 602.70 Mopath procedure level 681406 565.76 Mopath procedure level 781407 1692.54 Mopath procedure level 881408 4000.00 Mopath procedure level 981410 1008.00 Aortic dysfunction/dilation81411 2700.38 Aortic dysfunction/dilation81412 4897.12 Ashkenazi jewish assoc dis81413 1444.20 Car ion chnnlpath inc 10 gns81414 1444.20 Car ion chnnlpath inc 2 gns81415 9560.00 Exome sequence analysis81416 24000.00 Exome sequence analysis81417 640.00 Exome re-evaluation81420 1518.10 Fetal chrmoml aneuploidy81422 1518.10 Fetal chrmoml microdeltj81425 0.00 Genome sequence analysis81426 0.00 Genome sequence analysis81427 0.00 Genome re-evaluation81430 3250.00 Hearing loss sequence analys81431 1359.14 Hearing loss dup/del analys81432 1676.66 Hrdtry brst ca-rlatd dsordrs81433 1083.78 Hrdtry brst ca-rlatd dsordrs81434 1195.82 Hereditary retinal disorders81435 1444.20 Hereditary colon ca dsordrs

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HCPCS RATE2018 SHORTDESC81436 1444.20 Hereditary colon ca dsordrs81437 1083.78 Heredtry nurondcrn tum dsrdr81438 1083.78 Heredtry nurondcrn tum dsrdr81439 1444.20 Hrdtry cardmypy gene panel81440 6648.00 Mitochondrial gene81442 4287.20 Noonan spectrum disorders81445 1195.82 Targeted genomic seq analys81448 1444.20 Hrdtry perph neurphy panel81450 1519.06 Targeted genomic seq analys81455 5839.20 Targeted genomic seq analys81460 2574.00 Whole mitochondrial genome81465 1872.00 Whole mitochondrial genome81470 0.00 X-linked intellectual dblt81471 0.00 X-linked intellectual dblt81490 1681.30 Autoimmune rheumatoid arthr81493 2100.00 Cor artery disease mrna81500 521.00 Onco (ovar) two proteins81503 1794.00 Onco (ovar) five proteins81504 1040.00 Oncology tissue of origin81506 162.06 Endo assay seven anal81507 1590.00 Fetal aneuploidy trisom risk81508 108.60 Ftl cgen abnor two proteins81509 2974.74 Ftl cgen abnor 3 proteins81510 111.08 Ftl cgen abnor three anal81511 307.00 Ftl cgen abnor four anal81512 139.04 Ftl cgen abnor five anal81519 7746.00 Oncology breast mrna81520 6198.04 Onc breast mrna 58 genes81521 7746.00 Onc breast mrna 70 genes81525 6232.00 Oncology colon mrna81528 1017.74 Oncology colorectal scr81535 1158.92 Oncology gynecologic81536 355.12 Oncology gynecologic81538 5742.00 Oncology lung81539 1520.00 Oncology prostate prob score81540 7500.00 Oncology tum unknown origin81541 7746.00 Onc prostate mrna 46 genes81545 7200.00 Oncology thyroid81551 0.00 Onc prostate 3 genes81595 6480.00 Cardiology hrt trnspl mrna82009 11.16 Test for acetone/ketones82010 20.18 Acetone assay82010 20.18 Acetone assay

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HCPCS RATE2018 SHORTDESC82013 27.58 Acetylcholinesterase assay82016 34.26 Acylcarnitines qual82017 41.66 Acylcarnitines quant82024 95.36 Assay of acth82030 63.70 Assay of adp & amp82040 12.22 Assay of serum albumin82040 12.22 Assay of serum albumin82042 15.56 Other source albumin quan ea82042 15.56 Other source albumin quan ea82043 14.28 Ur albumin quantitative82043 14.28 Ur albumin quantitative82044 12.46 Ur albumin semiquantitative82044 12.46 Ur albumin semiquantitative82045 83.80 Albumin ischemia modified82075 60.00 Assay of breath ethanol82085 23.98 Assay of aldolase82088 100.62 Assay of aldosterone82103 33.18 Alpha-1-antitrypsin total82104 35.72 Alpha-1-antitrypsin pheno82105 41.42 Alpha-fetoprotein serum82106 41.42 Alpha-fetoprotein amniotic82107 159.04 Alpha-fetoprotein l382108 62.92 Assay of aluminum82120 11.98 Amines vaginal fluid qual82120 11.98 Amines vaginal fluid qual82127 34.26 Amino acid single qual82128 34.26 Amino acids mult qual82131 45.96 Amino acids single quant82135 40.62 Assay aminolevulinic acid82136 41.66 Amino acids quant 2-582139 41.66 Amino acids quan 6 or more82140 35.98 Assay of ammonia82143 18.70 Amniotic fluid scan82150 16.00 Assay of amylase82150 16.00 Assay of amylase82154 71.20 Androstanediol glucuronide82157 72.28 Assay of androstenedione82160 61.74 Assay of androsterone82163 50.68 Assay of angiotensin ii82164 36.06 Angiotensin i enzyme test82172 42.18 Assay of apolipoprotein82175 46.84 Assay of arsenic82180 24.40 Assay of ascorbic acid

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HCPCS RATE2018 SHORTDESC82190 36.82 Atomic absorption82232 39.94 Assay of beta-2 protein82239 42.28 Bile acids total82240 65.62 Bile acids cholylglycine82247 12.38 Bilirubin total82247 12.38 Bilirubin total82248 12.38 Bilirubin direct82252 11.26 Fecal bilirubin test82261 41.66 Assay of biotinidase82270 8.76 Occult blood feces82271 10.64 Occult blood other sources82271 10.64 Occult blood other sources82272 8.46 Occult bld feces 1-3 tests82274 39.28 Assay test for blood fecal82274 39.28 Assay test for blood fecal82286 12.74 Assay of bradykinin82300 57.16 Assay of cadmium82306 73.10 Vitamin d 25 hydroxy82308 66.16 Assay of calcitonin82310 12.74 Assay of calcium82310 12.74 Assay of calcium82330 33.76 Assay of calcium82330 33.76 Assay of calcium82331 26.68 Calcium infusion test82340 14.88 Assay of calcium in urine82355 28.58 Calculus analysis qual82360 31.78 Calculus assay quant82365 31.84 Calculus spectroscopy82370 30.92 X-ray assay calculus82373 44.58 Assay c-d transfer measure82374 12.06 Assay blood carbon dioxide82374 12.06 Assay blood carbon dioxide82375 30.42 Assay carboxyhb quant82376 28.14 Assay carboxyhb qual82378 46.82 Carcinoembryonic antigen82379 41.66 Assay of carnitine82380 22.78 Assay of carotene82382 54.60 Assay urine catecholamines82383 61.86 Assay blood catecholamines82384 62.36 Assay three catecholamines82387 44.58 Assay of cathepsin-d82390 26.52 Assay of ceruloplasmin82397 34.86 Chemiluminescent assay

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HCPCS RATE2018 SHORTDESC82415 31.28 Assay of chloramphenicol82435 11.36 Assay of blood chloride82435 11.36 Assay of blood chloride82436 12.42 Assay of urine chloride82438 12.06 Assay other fluid chlorides82441 14.84 Test for chlorohydrocarbons82465 10.74 Assay bld/serum cholesterol82465 10.74 Assay bld/serum cholesterol82480 19.44 Assay serum cholinesterase82482 19.62 Assay rbc cholinesterase82485 51.00 Assay chondroitin sulfate82495 50.08 Assay of chromium82507 68.66 Assay of citrate82523 46.14 Collagen crosslinks82523 46.14 Collagen crosslinks82525 30.64 Assay of copper82528 55.60 Assay of corticosterone82530 41.26 Cortisol free82533 40.24 Total cortisol82540 11.44 Assay of creatine82542 48.18 Col chromotography qual/quan82550 16.08 Assay of ck (cpk)82550 16.08 Assay of ck (cpk)82552 33.06 Assay of cpk in blood82553 28.52 Creatine mb fraction82554 29.30 Creatine isoforms82565 12.66 Assay of creatinine82565 12.66 Assay of creatinine82570 12.78 Assay of urine creatinine82570 12.78 Assay of urine creatinine82575 23.34 Creatinine clearance test82585 28.28 Assay of cryofibrinogen82595 15.96 Assay of cryoglobulin82600 47.90 Assay of cyanide82607 37.22 Vitamin b-1282608 35.36 B-12 binding capacity82610 37.04 Cystatin c82615 20.16 Test for urine cystines82626 62.40 Dehydroepiandrosterone82627 54.90 Dehydroepiandrosterone82633 76.50 Desoxycorticosterone82634 72.28 Deoxycortisol82638 30.24 Assay of dibucaine number

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HCPCS RATE2018 SHORTDESC82652 95.06 Vit d 1 25-dihydroxy82656 28.48 Pancreatic elastase fecal82657 44.58 Enzyme cell activity82658 88.06 Enzyme cell activity ra82664 123.00 Electrophoretic test82668 46.40 Assay of erythropoietin82670 68.98 Assay of estradiol82671 79.76 Assay of estrogens82672 53.56 Assay of estrogen82677 59.70 Assay of estriol82679 61.62 Assay of estrone82679 61.62 Assay of estrone82693 36.80 Assay of ethylene glycol82696 58.24 Assay of etiocholanolone82705 12.58 Fats/lipids feces qual82710 41.50 Fats/lipids feces quant82715 45.94 Assay of fecal fat82725 37.54 Assay of blood fatty acids82726 44.58 Long chain fatty acids82728 33.66 Assay of ferritin82731 159.04 Assay of fetal fibronectin82735 45.78 Assay of fluoride82746 36.30 Assay of folic acid serum82747 42.76 Assay of folic acid rbc82757 42.80 Assay of semen fructose82759 53.04 Assay of rbc galactokinase82760 27.64 Assay of galactose82775 52.02 Assay galactose transferase82776 23.48 Galactose transferase test82777 88.50 Galectin-382784 22.96 Assay iga/igd/igg/igm each82785 40.64 Assay of ige82787 19.80 Igg 1 2 3 or 4 each82800 22.00 Blood ph82803 52.14 Blood gases any combination82805 157.54 Blood gases w/o2 saturation82810 21.54 Blood gases o2 sat only82820 26.68 Hemoglobin-oxygen affinity82930 13.44 Gastric analy w/ph ea spec82938 43.68 Gastrin test82941 43.54 Assay of gastrin82943 35.28 Assay of glucagon82945 9.70 Glucose other fluid

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HCPCS RATE2018 SHORTDESC82946 37.22 Glucagon tolerance test82947 9.70 Assay glucose blood quant82947 9.70 Assay glucose blood quant82948 10.08 Reagent strip/blood glucose82950 11.72 Glucose test82950 11.72 Glucose test82951 31.78 Glucose tolerance test (gtt)82951 31.78 Glucose tolerance test (gtt)82952 9.68 Gtt-added samples82952 9.68 Gtt-added samples82955 23.94 Assay of g6pd enzyme82960 14.94 Test for g6pd enzyme82962 6.56 Glucose blood test82963 53.04 Assay of glucosidase82965 26.30 Assay of gdh enzyme82977 17.78 Assay of ggt82977 17.78 Assay of ggt82978 35.20 Assay of glutathione82979 23.32 Assay rbc glutathione82985 37.22 Assay of glycated protein82985 37.22 Assay of glycated protein83001 45.88 Assay of gonadotropin (fsh)83001 45.88 Assay of gonadotropin (fsh)83002 45.72 Assay of gonadotropin (lh)83002 45.72 Assay of gonadotropin (lh)83003 41.16 Assay growth hormone (hgh)83006 151.20 Growth stimulation gene 283009 166.32 H pylori (c-13) blood83010 31.06 Assay of haptoglobin quant83012 53.78 Assay of haptoglobins83013 166.32 H pylori (c-13) breath83014 19.40 H pylori drug admin83015 46.50 Heavy metal qual any anal83018 54.24 Heavy metal quant each nes83020 31.78 Hemoglobin electrophoresis83021 44.58 Hemoglobin chromotography83026 8.02 Hemoglobin copper sulfate83030 21.48 Fetal hemoglobin chemical83033 16.00 Fetal hemoglobin assay qual83036 23.98 Glycosylated hemoglobin test83036 23.98 Glycosylated hemoglobin test83037 23.98 Glycosylated hb home device83037 23.98 Glycosylated hb home device

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HCPCS RATE2018 SHORTDESC83045 12.98 Blood methemoglobin test83050 18.10 Blood methemoglobin assay83051 18.06 Assay of plasma hemoglobin83060 20.42 Blood sulfhemoglobin assay83065 18.00 Assay of hemoglobin heat83068 20.90 Hemoglobin stability screen83069 9.76 Assay of urine hemoglobin83070 11.72 Assay of hemosiderin qual83080 41.66 Assay of b hexosaminidase83088 72.92 Assay of histamine83090 41.66 Assay of homocystine83150 47.78 Assay of homovanillic acid83491 43.28 Assay of corticosteroids 1783497 31.84 Assay of 5-hiaa83498 67.08 Assay of progesterone 17-d83500 55.92 Assay free hydroxyproline83505 60.02 Assay total hydroxyproline83516 28.48 Immunoassay nonantibody83516 28.48 Immunoassay nonantibody83518 20.94 Immunoassay dipstick83518 20.94 Immunoassay dipstick83519 36.80 Ria nonantibody83520 34.54 Immunoassay quant nos nonab83520 34.54 Immunoassay quant nos nonab83525 28.22 Assay of insulin83527 31.96 Assay of insulin83528 39.64 Assay of intrinsic factor83540 15.98 Assay of iron83550 21.58 Iron binding test83570 21.86 Assay of idh enzyme83582 35.00 Assay of ketogenic steroids83586 31.60 Assay 17- ketosteroids83593 64.94 Fractionation ketosteroids83605 26.38 Assay of lactic acid83605 26.38 Assay of lactic acid83615 14.90 Lactate (ld) (ldh) enzyme83625 31.60 Assay of ldh enzymes83630 48.48 Lactoferrin fecal (qual)83631 48.48 Lactoferrin fecal (quant)83632 49.94 Placental lactogen83633 22.50 Test urine for lactose83655 29.90 Assay of lead83655 29.90 Assay of lead

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HCPCS RATE2018 SHORTDESC83661 54.28 L/s ratio fetal lung83662 46.70 Foam stability fetal lung83663 46.70 Fluoro polarize fetal lung83664 46.70 Lamellar bdy fetal lung83670 22.62 Assay of lap enzyme83690 17.02 Assay of lipase83695 31.96 Assay of lipoprotein(a)83698 92.62 Assay lipoprotein pla283700 27.80 Lipopro bld electrophoretic83701 67.72 Lipoprotein bld hr fraction83704 77.90 Lipoprotein bld quan part83718 20.24 Assay of lipoprotein83718 20.24 Assay of lipoprotein83719 28.72 Assay of blood lipoprotein83721 23.56 Assay of blood lipoprotein83721 23.56 Assay of blood lipoprotein83727 42.44 Assay of lrh hormone83735 16.54 Assay of magnesium83775 18.20 Assay malate dehydrogenase83785 60.74 Assay of manganese83789 48.22 Mass spectrometry qual/quan83825 40.14 Assay of mercury83835 41.84 Assay of metanephrines83857 26.52 Assay of methemalbumin83861 44.96 Microfluid analy tears83861 44.96 Microfluid analy tears83864 57.00 Mucopolysaccharides83872 14.48 Assay synovial fluid mucin83873 42.48 Assay of csf protein83874 31.90 Assay of myoglobin83876 101.72 Assay myeloperoxidase83880 83.80 Assay of natriuretic peptide83880 83.80 Assay of natriuretic peptide83883 33.58 Assay nephelometry not spec83885 60.52 Assay of nickel83915 27.54 Assay of nucleotidase83916 54.78 Oligoclonal bands83918 47.20 Organic acids total quant83919 40.62 Organic acids qual each83921 42.42 Organic acid single quant83930 16.32 Assay of blood osmolality83935 16.84 Assay of urine osmolality83937 73.70 Assay of osteocalcin

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HCPCS RATE2018 SHORTDESC83945 31.78 Assay of oxalate83950 159.04 Oncoprotein her-2/neu83951 159.04 Oncoprotein dcp83970 101.92 Assay of parathormone83986 8.84 Assay ph body fluid nos83986 8.84 Assay ph body fluid nos83987 8.84 Exhaled breath condensate83993 48.48 Assay for calprotectin fecal84030 13.58 Assay of blood pku84035 9.04 Assay of phenylketones84060 18.24 Assay acid phosphatase84066 23.86 Assay prostate phosphatase84075 12.78 Assay alkaline phosphatase84075 12.78 Assay alkaline phosphatase84078 18.02 Assay alkaline phosphatase84080 36.50 Assay alkaline phosphatases84081 40.78 Assay phosphatidylglycerol84085 23.32 Assay of rbc pg6d enzyme84087 25.48 Assay phosphohexose enzymes84100 11.70 Assay of phosphorus84105 12.78 Assay of urine phosphorus84106 11.64 Test for porphobilinogen84110 20.84 Assay of porphobilinogen84112 196.22 Eval amniotic fluid protein84119 26.72 Test urine for porphyrins84120 36.32 Assay of urine porphyrins84126 78.22 Assay of feces porphyrins84132 11.36 Assay of serum potassium84132 11.36 Assay of serum potassium84133 10.64 Assay of urine potassium84134 36.02 Assay of prealbumin84135 47.26 Assay of pregnanediol84138 46.74 Assay of pregnanetriol84140 51.04 Assay of pregnenolone84143 56.32 Assay of 17-hydroxypregneno84144 51.52 Assay of progesterone84145 66.16 Procalcitonin (pct)84146 47.84 Assay of prolactin84150 83.54 Assay of prostaglandin84152 45.42 Assay of psa complexed84153 45.42 Assay of psa total84154 45.42 Assay of psa free84155 9.06 Assay of protein serum

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HCPCS RATE2018 SHORTDESC84155 9.06 Assay of protein serum84156 9.06 Assay of protein urine84157 9.06 Assay of protein other84157 9.06 Assay of protein other84160 12.78 Assay of protein any source84163 37.18 Pappa serum84165 26.52 Protein e-phoresis serum84166 44.02 Protein e-phoresis/urine/csf84181 42.04 Western blot test84182 58.42 Protein western blot test84202 35.42 Assay rbc protoporphyrin84203 21.26 Test rbc protoporphyrin84206 53.38 Assay of proinsulin84207 69.38 Assay of vitamin b-684210 28.96 Assay of pyruvate84220 23.32 Assay of pyruvate kinase84228 28.72 Assay of quinine84233 175.76 Assay of estrogen84234 160.20 Assay of progesterone84235 142.46 Assay of endocrine hormone84238 90.28 Assay nonendocrine receptor84244 54.30 Assay of renin84252 49.96 Assay of vitamin b-284255 63.04 Assay of selenium84260 76.50 Assay of serotonin84270 53.66 Assay of sex hormone globul84275 33.18 Assay of sialic acid84285 58.12 Assay of silica84295 11.88 Assay of serum sodium84295 11.88 Assay of serum sodium84300 12.00 Assay of urine sodium84302 12.00 Assay of sweat sodium84305 52.50 Assay of somatomedin84307 45.12 Assay of somatostatin84311 17.26 Spectrophotometry84315 6.56 Body fluid specific gravity84375 78.00 Chromatogram assay sugars84376 13.58 Sugars single qual84377 13.58 Sugars multiple qual84378 28.46 Sugars single quant84379 28.46 Sugars multiple quant84392 11.72 Assay of urine sulfate84402 62.90 Assay of free testosterone

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HCPCS RATE2018 SHORTDESC84403 63.74 Assay of total testosterone84410 126.64 Testosterone bioavailable84425 52.42 Assay of vitamin b-184430 28.72 Assay of thiocyanate84431 70.22 Thromboxane urine84432 39.66 Assay of thyroglobulin84436 16.96 Assay of total thyroxine84437 15.96 Assay of neonatal thyroxine84439 22.26 Assay of free thyroxine84442 36.50 Assay of thyroid activity84443 41.50 Assay thyroid stim hormone84443 41.50 Assay thyroid stim hormone84445 125.56 Assay of tsi globulin84446 35.02 Assay of vitamin e84449 44.44 Assay of transcortin84450 12.78 Transferase (ast) (sgot)84450 12.78 Transferase (ast) (sgot)84460 13.08 Alanine amino (alt) (sgpt)84460 13.08 Alanine amino (alt) (sgpt)84466 31.52 Assay of transferrin84478 14.18 Assay of triglycerides84478 14.18 Assay of triglycerides84479 15.96 Assay of thyroid (t3 or t4)84480 35.02 Assay triiodothyronine (t3)84481 41.84 Free assay (ft-3)84482 38.92 T3 reverse84484 24.94 Assay of troponin quant84485 17.78 Assay duodenal fluid trypsin84488 18.02 Test feces for trypsin84490 19.86 Assay of feces for trypsin84510 25.68 Assay of tyrosine84512 20.18 Assay of troponin qual84520 9.76 Assay of urea nitrogen84520 9.76 Assay of urea nitrogen84525 10.26 Urea nitrogen semi-quant84540 11.72 Assay of urine/urea-n84545 16.32 Urea-n clearance test84550 11.16 Assay of blood/uric acid84550 11.16 Assay of blood/uric acid84560 11.72 Assay of urine/uric acid84577 41.50 Assay of feces/urobilinogen84578 8.94 Test urine urobilinogen84580 20.16 Assay of urine urobilinogen

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HCPCS RATE2018 SHORTDESC84583 12.42 Assay of urine urobilinogen84585 38.26 Assay of urine vma84586 87.24 Assay of vip84588 83.80 Assay of vasopressin84590 28.66 Assay of vitamin a84591 34.12 Assay of nos vitamin84597 33.88 Assay of vitamin k84600 39.70 Assay of volatiles84620 29.26 Xylose tolerance test84630 28.12 Assay of zinc84681 51.40 Assay of c-peptide84702 37.18 Chorionic gonadotropin test84703 18.58 Chorionic gonadotropin assay84703 18.58 Chorionic gonadotropin assay84704 37.18 Hcg free betachain test84830 25.40 Ovulation tests85002 11.14 Bleeding time test85004 15.96 Automated diff wbc count85007 8.48 Bl smear w/diff wbc count85008 8.48 Bl smear w/o diff wbc count85009 10.14 Manual diff wbc count b-coat85013 14.00 Spun microhematocrit85014 5.86 Hematocrit85014 5.86 Hematocrit85018 5.86 Hemoglobin85018 5.86 Hemoglobin85025 19.18 Complete cbc w/auto diff wbc85025 19.18 Complete cbc w/auto diff wbc85027 15.96 Complete cbc automated85032 10.64 Manual cell count each85041 7.46 Automated rbc count85044 10.64 Manual reticulocyte count85045 9.86 Automated reticulocyte count85046 13.76 Reticyte/hgb concentrate85048 6.26 Automated leukocyte count85049 11.06 Automated platelet count85055 71.48 Reticulated platelet assay85130 29.36 Chromogenic substrate assay85170 32.60 Blood clot retraction85175 40.74 Blood clot lysis time85210 32.06 Clot factor ii prothrom spec85220 43.58 Blooc clot factor v test85230 44.20 Clot factor vii proconvertin

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HCPCS RATE2018 SHORTDESC85240 44.20 Clot factor viii ahg 1 stage85244 50.42 Clot factor viii reltd antgn85245 56.64 Clot factor viii vw ristoctn85246 56.64 Clot factor viii vw antigen85247 56.64 Clot factor viii multimetric85250 47.02 Clot factor ix ptc/chrstmas85260 44.20 Clot factor x stuart-power85270 44.20 Clot factor xi pta85280 47.78 Clot factor xii hageman85290 40.34 Clot factor xiii fibrin stab85291 21.96 Clot factor xiii fibrin scrn85292 46.74 Clot factor fletcher fact85293 46.74 Clot factor wght kininogen85300 29.26 Antithrombin iii activity85301 26.70 Antithrombin iii antigen85302 29.66 Clot inhibit prot c antigen85303 34.16 Clot inhibit prot c activity85305 28.66 Clot inhibit prot s total85306 37.84 Clot inhibit prot s free85307 37.84 Assay activated protein c85335 31.78 Factor inhibitor test85337 34.54 Thrombomodulin85345 10.64 Coagulation time lee & white85347 10.52 Coagulation time activated85348 9.20 Coagulation time otr method85360 20.76 Euglobulin lysis85362 17.02 Fibrin degradation products85366 160.92 Fibrinogen test85370 28.04 Fibrinogen test85378 19.44 Fibrin degrade semiquant85379 25.12 Fibrin degradation quant85380 25.12 Fibrin degradj d-dimer85384 20.98 Fibrinogen activity85385 28.92 Fibrinogen antigen85390 30.96 Fibrinolysins screen i&r85397 61.72 Clotting funct activity85400 19.02 Fibrinolytic plasmin85410 19.02 Fibrinolytic antiplasmin85415 42.44 Fibrinolytic plasminogen85420 16.12 Fibrinolytic plasminogen85421 25.14 Fibrinolytic plasminogen85441 10.36 Heinz bodies direct85445 16.84 Heinz bodies induced

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HCPCS RATE2018 SHORTDESC85460 19.10 Hemoglobin fetal85461 18.72 Hemoglobin fetal85475 21.90 Hemolysin acid85520 32.32 Heparin assay85525 29.24 Heparin neutralization85530 32.32 Heparin-protamine tolerance85536 15.96 Iron stain peripheral blood85540 21.24 Wbc alkaline phosphatase85547 21.24 Rbc mechanical fragility85549 46.30 Muramidase85555 16.50 Rbc osmotic fragility85557 32.98 Rbc osmotic fragility85576 53.04 Blood platelet aggregation85576 53.04 Blood platelet aggregation85597 44.38 Phospholipid pltlt neutraliz85598 44.38 Hexagnal phosph pltlt neutrl85610 9.70 Prothrombin time85610 9.70 Prothrombin time85611 9.74 Prothrombin test85612 34.98 Viper venom prothrombin time85613 23.66 Russell viper venom diluted85635 24.32 Reptilase test85651 8.76 Rbc sed rate nonautomated85652 6.66 Rbc sed rate automated85660 13.60 Rbc sickle cell test85670 14.24 Thrombin time plasma85675 16.90 Thrombin time titer85705 23.78 Thromboplastin inhibition85730 14.84 Thromboplastin time partial85732 15.96 Thromboplastin time partial85810 28.82 Blood viscosity examination86000 17.24 Agglutinins febrile antigen86001 15.64 Allergen specific igg86003 12.88 Allg spec ige crude xtrc ea86005 19.68 Allg spec ige multiallg scr86008 44.28 Allg spec ige recomb ea86021 37.18 Wbc antibody identification86022 45.36 Platelet antibodies86023 30.76 Immunoglobulin assay86038 29.84 Antinuclear antibodies86039 27.56 Antinuclear antibodies (ana)86060 18.02 Antistreptolysin o titer86063 14.24 Antistreptolysin o screen

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HCPCS RATE2018 SHORTDESC86140 12.78 C-reactive protein86141 31.96 C-reactive protein hs86146 62.84 Beta-2 glycoprotein antibody86147 62.84 Cardiolipin antibody ea ig86148 39.68 Anti-phospholipid antibody86152 606.68 Cell enumeration & id86155 39.48 Chemotaxis assay86156 16.54 Cold agglutinin screen86157 19.90 Cold agglutinin titer86160 29.62 Complement antigen86161 29.62 Complement/function activity86162 50.18 Complement total (ch50)86171 24.72 Complement fixation each86200 31.96 Ccp antibody86215 32.70 Deoxyribonuclease antibody86225 33.94 Dna antibody native86226 29.90 Dna antibody single strand86235 44.28 Nuclear antigen antibody86255 29.76 Fluorescent antibody screen86256 29.76 Fluorescent antibody titer86277 38.86 Growth hormone antibody86280 20.24 Hemagglutination inhibition86294 51.14 Immunoassay tumor qual86294 51.14 Immunoassay tumor qual86300 51.40 Immunoassay tumor ca 15-386301 51.40 Immunoassay tumor ca 19-986304 51.40 Immunoassay tumor ca 12586305 51.40 Human epididymis protein 486308 12.78 Heterophile antibody screen86308 12.78 Heterophile antibody screen86309 15.96 Heterophile antibody titer86310 18.20 Heterophile antibody absrbj86316 51.40 Immunoassay tumor other86317 37.00 Immunoassay infectious agent86318 36.18 Immunoassay infectious agent86318 36.18 Immunoassay infectious agent86320 59.84 Serum immunoelectrophoresis86325 55.22 Other immunoelectrophoresis86327 59.84 Immunoelectrophoresis assay86329 34.68 Immunodiffusion nes86331 29.58 Immunodiffusion ouchterlony86332 60.18 Immune complex assay86334 55.18 Immunofix e-phoresis serum

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HCPCS RATE2018 SHORTDESC86335 72.46 Immunfix e-phorsis/urine/csf86336 38.48 Inhibin a86337 52.86 Insulin antibodies86340 37.22 Intrinsic factor antibody86341 48.86 Islet cell antibody86343 30.76 Leukocyte histamine release86344 20.78 Leukocyte phagocytosis86352 335.46 Cell function assay w/stim86353 121.06 Lymphocyte transformation86355 93.16 B cells total count86356 66.12 Mononuclear cell antigen86357 93.16 Nk cells total count86359 93.16 T cells total count86360 116.02 T cell absolute count/ratio86361 66.12 T cell absolute count86367 155.56 Stem cells total count86376 35.92 Microsomal antibody each86382 41.76 Neutralization test viral86384 28.12 Nitroblue tetrazolium dye86386 43.56 Nuclear matrix protein 2286386 43.56 Nuclear matrix protein 2286403 25.16 Particle agglut antbdy scrn86406 26.26 Particle agglut antbdy titr86430 14.00 Rheumatoid factor test qual86431 14.00 Rheumatoid factor quant86480 153.04 Tb test cell immun measure86481 200.00 Tb ag response t-cell susp86590 27.28 Streptokinase antibody86592 10.54 Syphilis test non-trep qual86593 10.88 Syphilis test non-trep quant86602 25.12 Antinomyces antibody86603 31.78 Adenovirus antibody86606 37.18 Aspergillus antibody86609 31.80 Bacterium antibody86611 25.12 Bartonella antibody86612 31.86 Blastomyces antibody86615 32.56 Bordetella antibody86617 38.26 Lyme disease antibody86618 42.04 Lyme disease antibody86618 42.04 Lyme disease antibody86619 33.04 Borrelia antibody86622 22.06 Brucella antibody86625 32.40 Campylobacter antibody

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HCPCS RATE2018 SHORTDESC86628 29.64 Candida antibody86631 29.20 Chlamydia antibody86632 31.32 Chlamydia igm antibody86635 28.34 Coccidioides antibody86638 29.94 Q fever antibody86641 35.58 Cryptococcus antibody86644 35.54 Cmv antibody86645 41.60 Cmv antibody igm86648 37.54 Diphtheria antibody86651 32.56 Encephalitis californ antbdy86652 32.56 Encephaltis east eqne anbdy86653 32.56 Encephaltis st louis antbody86654 32.56 Encephaltis west eqne antbdy86658 32.16 Enterovirus antibody86663 32.40 Epstein-barr antibody86664 37.76 Epstein-barr nuclear antigen86665 44.80 Epstein-barr capsid vca86666 25.12 Ehrlichia antibody86668 28.32 Francisella tularensis86671 30.26 Fungus nes antibody86674 36.34 Giardia lamblia antibody86677 35.82 Helicobacter pylori antibody86682 32.12 Helminth antibody86684 39.12 Hemophilus influenza antibdy86687 20.72 Htlv-i antibody86688 34.58 Htlv-ii antibody86689 47.80 Htlv/hiv confirmj antibody86692 42.38 Hepatitis delta agent antbdy86694 35.54 Herpes simplex nes antbdy86695 32.56 Herpes simplex type 1 test86696 47.80 Herpes simplex type 2 test86698 30.86 Histoplasma antibody86701 21.94 Hiv-1antibody86701 21.94 Hiv-1antibody86702 33.38 Hiv-2 antibody86703 33.84 Hiv-1/hiv-2 1 result antbdy86704 29.76 Hep b core antibody total86705 29.08 Hep b core antibody igm86706 26.52 Hep b surface antibody86707 28.56 Hepatitis be antibody86708 30.58 Hepatitis a antibody86709 27.80 Hepatitis a igm antibody86710 33.46 Influenza virus antibody

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HCPCS RATE2018 SHORTDESC86711 35.54 John cunningham antibody86713 37.78 Legionella antibody86717 30.24 Leishmania antibody86720 32.56 Leptospira antibody86723 32.56 Listeria monocytogenes86727 31.78 Lymph choriomeningitis ab86732 32.56 Mucormycosis antibody86735 32.22 Mumps antibody86738 32.68 Mycoplasma antibody86741 32.56 Neisseria meningitidis86744 32.56 Nocardia antibody86747 37.12 Parvovirus antibody86750 32.56 Malaria antibody86753 30.58 Protozoa antibody nos86756 31.82 Respiratory virus antibody86757 47.80 Rickettsia antibody86759 36.46 Rotavirus antibody86762 35.54 Rubella antibody86765 31.80 Rubeola antibody86768 32.56 Salmonella antibody86771 48.96 Shigella antibody86774 36.54 Tetanus antibody86777 35.54 Toxoplasma antibody86778 35.56 Toxoplasma antibody igm86780 32.68 Treponema pallidum86780 32.68 Treponema pallidum86784 31.02 Trichinella antibody86787 31.80 Varicella-zoster antibody86788 41.60 West nile virus ab igm86789 35.54 West nile virus antibody86790 31.80 Virus antibody nos86793 32.56 Yersinia antibody86794 41.60 Zika virus igm antibody86800 39.28 Thyroglobulin antibody86803 35.22 Hepatitis c ab test86803 35.22 Hepatitis c ab test86804 38.26 Hep c ab test confirm86805 379.02 Lymphocytotoxicity assay86806 117.50 Lymphocytotoxicity assay86807 157.30 Cytotoxic antibody screening86808 73.28 Cytotoxic antibody screening86812 63.72 Hla typing a b or c86813 143.20 Hla typing a b or c

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HCPCS RATE2018 SHORTDESC86816 68.78 Hla typing dr/dq86817 212.28 Hla typing dr/dq86821 90.28 Lymphocyte culture mixed86825 218.98 Hla x-math non-cytotoxic86826 73.06 Hla x-match noncytotoxc addl86828 128.38 Hla class i&ii antibody qual86829 128.38 Hla class i/ii antibody qual86830 199.36 Hla class i phenotype qual86831 170.88 Hla class ii phenotype qual86832 647.50 Hla class i high defin qual86833 651.60 Hla class ii high defin qual86834 882.86 Hla class i semiquant panel86835 797.44 Hla class ii semiquant panel86850 19.54 Rbc antibody screen86880 13.30 Coombs test direct86885 14.14 Coombs test indirect qual86886 12.78 Coombs test indirect titer86900 7.38 Blood typing serologic abo86901 7.38 Blood typing serologic rh(d)86902 12.70 Blood type antigen donor ea86904 32.68 Blood typing patient serum86905 9.46 Blood typing rbc antigens86906 19.14 Bld typing serologic rh phnt86940 20.26 Hemolysins/agglutinins auto86941 29.90 Hemolysins/agglutinins87003 41.58 Small animal inoculation87015 16.48 Specimen infect agnt concntj87040 25.48 Blood culture for bacteria87045 23.32 Feces culture aerobic bact87046 23.32 Stool cultr aerobic bact ea87070 21.28 Culture othr specimn aerobic87071 23.32 Culture aerobic quant other87073 23.32 Culture bacteria anaerobic87075 23.38 Cultr bacteria except blood87076 19.94 Culture anaerobe ident each87077 19.94 Culture aerobic identify87077 19.94 Culture aerobic identify87081 16.36 Culture screen only87084 54.14 Culture of specimen by kit87086 19.92 Urine culture/colony count87088 19.98 Urine bacteria culture87101 19.02 Skin fungi culture87102 20.76 Fungus isolation culture

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HCPCS RATE2018 SHORTDESC87103 40.92 Blood fungus culture87106 25.48 Fungi identification yeast87107 25.48 Fungi identification mold87109 38.00 Mycoplasma87110 48.38 Chlamydia culture87116 26.68 Mycobacteria culture87118 29.22 Mycobacteric identification87140 13.76 Culture type immunofluoresc87143 30.92 Culture typing glc/hplc87147 12.78 Culture type immunologic87149 49.52 Dna/rna direct probe87150 86.66 Dna/rna amplified probe87152 15.48 Culture type pulse field gel87153 284.84 Dna/rna sequencing87158 15.48 Culture typing added method87164 26.52 Dark field examination87166 27.90 Dark field examination87168 10.54 Macroscopic exam arthropod87169 10.54 Macroscopic exam parasite87172 10.54 Pinworm exam87176 14.52 Tissue homogenization cultr87177 21.98 Ova and parasites smears87181 11.72 Microbe susceptible diffuse87184 17.02 Microbe susceptible disk87185 11.72 Microbe susceptible enzyme87186 21.34 Microbe susceptible mic87187 80.34 Microbe susceptible mlc87188 16.40 Microbe suscept macrobroth87190 14.62 Microbe suscept mycobacteri87197 37.10 Bactericidal level serum87205 10.54 Smear gram stain87206 13.30 Smear fluorescent/acid stai87207 14.80 Smear special stain87209 44.38 Smear complex stain87210 11.64 Smear wet mount saline/ink87210 11.64 Smear wet mount saline/ink87220 10.54 Tissue exam for fungi87230 48.74 Assay toxin or antitoxin87250 48.30 Virus inoculate eggs/animal87252 64.36 Virus inoculation tissue87253 49.88 Virus inoculate tissue addl87254 48.30 Virus inoculation shell via87255 83.62 Genet virus isolate hsv

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HCPCS RATE2018 SHORTDESC87260 29.60 Adenovirus ag if87265 29.60 Pertussis ag if87267 29.60 Enterovirus antibody dfa87269 29.60 Giardia ag if87270 29.60 Chlamydia trachomatis ag if87271 29.60 Cytomegalovirus dfa87272 29.60 Cryptosporidium ag if87273 29.60 Herpes simplex 2 ag if87274 29.60 Herpes simplex 1 ag if87275 29.60 Influenza b ag if87276 32.14 Influenza a ag if87278 31.20 Legion pneumophilia ag if87279 32.86 Parainfluenza ag if87280 29.60 Respiratory syncytial ag if87281 29.60 Pneumocystis carinii ag if87283 121.60 Rubeola ag if87285 29.60 Treponema pallidum ag if87290 29.60 Varicella zoster ag if87299 32.20 Antibody detection nos if87300 29.60 Ag detection polyval if87301 29.60 Adenovirus ag ia87305 29.60 Aspergillus ag ia87320 30.00 Chylmd trach ag ia87324 29.60 Clostridium ag ia87327 29.60 Cryptococcus neoform ag ia87328 29.60 Cryptosporidium ag ia87329 29.60 Giardia ag ia87332 29.60 Cytomegalovirus ag ia87335 29.60 E coli 0157 ag ia87336 32.00 Entamoeb hist dispr ag ia87337 29.60 Entamoeb hist group ag ia87338 35.52 Hpylori stool ia87338 35.52 Hpylori stool ia87339 32.00 H pylori ag ia87340 25.50 Hepatitis b surface ag ia87341 25.50 Hepatitis b surface ag ia87350 28.46 Hepatitis be ag ia87380 40.52 Hepatitis delta ag ia87385 29.60 Histoplasma capsul ag ia87389 59.46 Hiv-1 ag w/hiv-1 & hiv-2 ab87389 59.46 Hiv-1 ag w/hiv-1 & hiv-2 ab87390 48.12 Hiv-1 ag ia87391 43.80 Hiv-2 ag ia

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HCPCS RATE2018 SHORTDESC87400 29.60 Influenza a/b ag ia87420 29.60 Resp syncytial ag ia87425 29.60 Rotavirus ag ia87427 29.60 Shiga-like toxin ag ia87430 33.62 Strep a ag ia87449 29.60 Ag detect nos ia mult87449 29.60 Ag detect nos ia mult87450 23.68 Ag detect nos ia single87451 23.68 Ag detect polyval ia mult87471 86.66 Bartonella dna amp probe87472 105.76 Bartonella dna quant87475 49.52 Lyme dis dna dir probe87476 86.66 Lyme dis dna amp probe87480 49.52 Candida dna dir probe87481 86.66 Candida dna amp probe87482 111.48 Candida dna quant87483 1029.10 Cns dna amp probe type 12-2587485 49.52 Chylmd pneum dna dir probe87486 86.66 Chylmd pneum dna amp probe87487 105.76 Chylmd pneum dna quant87490 49.52 Chylmd trach dna dir probe87491 86.66 Chylmd trach dna amp probe87492 106.94 Chylmd trach dna quant87493 86.66 C diff amplified probe87495 60.06 Cytomeg dna dir probe87496 86.66 Cytomeg dna amp probe87497 105.76 Cytomeg dna quant87498 86.66 Enterovirus probe&revrs trns87500 86.66 Vanomycin dna amp probe87501 126.70 Influenza dna amp prob 1+87502 210.12 Influenza dna amp probe87502 210.12 Influenza dna amp probe87503 58.44 Influenza dna amp prob addl87505 316.76 Nfct agent detection gi87506 526.98 Iadna-dna/rna probe tq 6-1187507 1029.10 Iadna-dna/rna probe tq 12-2587510 49.52 Gardner vag dna dir probe87511 86.66 Gardner vag dna amp probe87512 103.10 Gardner vag dna quant87516 86.66 Hepatitis b dna amp probe87517 105.76 Hepatitis b dna quant87520 62.44 Hepatitis c rna dir probe87521 86.66 Hepatitis c probe&rvrs trnsc

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HCPCS RATE2018 SHORTDESC87522 105.76 Hepatitis c revrs trnscrpj87525 59.60 Hepatitis g dna dir probe87526 86.66 Hepatitis g dna amp probe87527 103.10 Hepatitis g dna quant87528 49.52 Hsv dna dir probe87529 86.66 Hsv dna amp probe87530 105.76 Hsv dna quant87531 116.00 Hhv-6 dna dir probe87532 86.66 Hhv-6 dna amp probe87533 103.10 Hhv-6 dna quant87534 49.52 Hiv-1 dna dir probe87535 86.66 Hiv-1 probe&reverse trnscrpj87536 210.12 Hiv-1 quant&revrse trnscrpj87537 49.52 Hiv-2 dna dir probe87538 86.66 Hiv-2 probe&revrse trnscripj87539 117.24 Hiv-2 quant&revrse trnscripj87540 49.52 Legion pneumo dna dir prob87541 86.66 Legion pneumo dna amp prob87542 103.10 Legion pneumo dna quant87550 49.52 Mycobacteria dna dir probe87551 96.48 Mycobacteria dna amp probe87552 105.76 Mycobacteria dna quant87555 53.76 M.tuberculo dna dir probe87556 86.66 M.tuberculo dna amp probe87557 105.76 M.tuberculo dna quant87560 54.58 M.avium-intra dna dir prob87561 86.66 M.avium-intra dna amp prob87562 105.76 M.avium-intra dna quant87580 49.52 M.pneumon dna dir probe87581 86.66 M.pneumon dna amp probe87582 605.24 M.pneumon dna quant87590 53.76 N.gonorrhoeae dna dir prob87591 86.66 N.gonorrhoeae dna amp prob87592 105.76 N.gonorrhoeae dna quant87623 86.66 Hpv low-risk types87624 86.66 Hpv high-risk types87625 86.66 Hpv types 16 & 18 only87631 316.76 Resp virus 3-5 targets87631 316.76 Resp virus 3-5 targets87632 526.98 Resp virus 6-11 targets87633 1029.10 Resp virus 12-25 targets87633 1029.10 Resp virus 12-25 targets87634 173.32 Rsv dna/rna amp probe

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HCPCS RATE2018 SHORTDESC87640 86.66 Staph a dna amp probe87641 86.66 Mr-staph dna amp probe87650 49.52 Strep a dna dir probe87650 49.52 Strep a dna dir probe87651 86.66 Strep a dna amp probe87651 86.66 Strep a dna amp probe87652 103.10 Strep a dna quant87653 86.66 Strep b dna amp probe87660 49.52 Trichomonas vagin dir probe87661 86.66 Trichomonas vaginalis amplif87662 126.70 Zika virus dna/rna amp probe87797 60.06 Detect agent nos dna dir87798 86.66 Detect agent nos dna amp87799 105.76 Detect agent nos dna quant87800 99.06 Detect agnt mult dna direc87801 173.32 Detect agnt mult dna ampli87801 173.32 Detect agnt mult dna ampli87802 29.60 Strep b assay w/optic87803 32.00 Clostridium toxin a w/optic87804 33.10 Influenza assay w/optic87804 33.10 Influenza assay w/optic87806 65.54 Hiv antigen w/hiv antibodies87806 65.54 Hiv antigen w/hiv antibodies87807 29.60 Rsv assay w/optic87807 29.60 Rsv assay w/optic87808 30.58 Trichomonas assay w/optic87808 30.58 Trichomonas assay w/optic87809 43.52 Adenovirus assay w/optic87809 43.52 Adenovirus assay w/optic87810 70.58 Chylmd trach assay w/optic87850 49.12 N. gonorrhoeae assay w/optic87880 33.06 Strep a assay w/optic87880 33.06 Strep a assay w/optic87899 32.14 Agent nos assay w/optic87899 32.14 Agent nos assay w/optic87900 321.84 Phenotype infect agent drug87901 635.68 Genotype dna hiv reverse t87902 635.68 Genotype dna/rna hep c87903 1206.56 Phenotype dna hiv w/culture87904 64.36 Phenotype dna hiv w/clt add87905 30.16 Sialidase enzyme assay87905 30.16 Sialidase enzyme assay87906 317.84 Genotype dna/rna hiv

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HCPCS RATE2018 SHORTDESC87910 635.68 Genotype cytomegalovirus87912 635.68 Genotype dna hepatitis b88130 44.38 Sex chromatin identification88140 19.72 Sex chromatin identification88142 50.02 Cytopath c/v thin layer88143 50.02 Cytopath c/v thin layer redo88147 101.12 Cytopath c/v automated88148 37.52 Cytopath c/v auto rescreen88150 29.30 Cytopath c/v manual88152 55.28 Cytopath c/v auto redo88153 48.06 Cytopath c/v redo88155 29.30 Cytopath c/v index add-on88164 29.30 Cytopath tbs c/v manual88165 84.44 Cytopath tbs c/v redo88166 29.30 Cytopath tbs c/v auto redo88167 29.30 Cytopath tbs c/v select88174 52.76 Cytopath c/v auto in fluid88175 65.42 Cytopath c/v auto fluid redo88230 287.64 Tissue culture lymphocyte88233 347.48 Tissue culture skin/biopsy88235 363.62 Tissue culture placenta88237 311.86 Tissue culture bone marrow88239 364.24 Tissue culture tumor88240 26.14 Cell cryopreserve/storage88241 24.94 Frozen cell preparation88245 427.60 Chromosome analysis 20-2588248 427.60 Chromosome analysis 50-10088249 427.60 Chromosome analysis 10088261 528.68 Chromosome analysis 588262 307.76 Chromosome analysis 15-2088263 371.08 Chromosome analysis 4588264 307.76 Chromosome analysis 20-2588267 443.90 Chromosome analys placenta88269 410.68 Chromosome analys amniotic88271 52.88 Cytogenetics dna probe88272 81.40 Cytogenetics 3-588273 79.32 Cytogenetics 10-3088274 85.96 Cytogenetics 25-9988275 102.38 Cytogenetics 100-30088280 66.94 Chromosome karyotype study88283 169.38 Chromosome banding study88285 53.82 Chromosome count additional88289 85.02 Chromosome study additional

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HCPCS RATE2018 SHORTDESC88371 54.88 Protein western blot tissue88372 56.16 Protein analysis w/probe88720 12.38 Bilirubin total transcut88738 12.38 Hgb quant transcutaneous88740 18.74 Transcutaneous carboxyhb88741 18.74 Transcutaneous methb89050 11.66 Body fluid cell count89051 13.60 Body fluid cell count89055 10.54 Leukocyte assessment fecal89060 17.66 Exam synovial fluid crystals89125 11.76 Specimen fat stain89160 9.70 Exam feces for meat fibers89190 11.72 Nasal smear for eosinophils89300 22.06 Semen analysis w/huhner89300 22.06 Semen analysis w/huhner89310 21.26 Semen analysis w/count89320 29.76 Semen anal vol/count/mot89321 29.76 Semen anal sperm detection89321 29.76 Semen anal sperm detection89322 38.26 Semen anal strict criteria89325 26.36 Sperm antibody test89329 48.36 Sperm evaluation test89330 24.42 Evaluation cervical mucus89331 48.36 Retrograde ejaculation analG0027 16.06 Semen analysisG0103 45.42 Psa screeningG0123 50.02 Screen cerv/vag thin layerG0143 54.10 Scr c/v cyto,thinlayer,rescrG0144 87.94 Scr c/v cyto,thinlayer,rescrG0145 65.42 Scr c/v cyto,thinlayer,rescrG0147 29.30 Scr c/v cyto, automated sysG0148 63.88 Scr c/v cyto, autosys, rescrG0306 19.18 Cbc/diffwbc w/o plateletG0307 15.96 Cbc without plateletG0328 39.28 Fecal blood scrn immunoassayG0328 39.28 Fecal blood scrn immunoassayG0432 39.14 Eia hiv-1/hiv-2 screenG0433 36.58 Elisa hiv-1/hiv-2 screenG0433 36.58 Elisa hiv-1/hiv-2 screenG0435 29.60 Oral hiv-1/hiv-2 screenG0471 10.00 Ven blood coll snf/hhaG0472 92.70 Hep c screen high risk/otherG0472 92.70 Hep c screen high risk/other

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HCPCS RATE2018 SHORTDESCG0475 59.46 Hiv combination assayG0475 59.46 Hiv combination assayG0476 86.66 Hpv combo assay ca screenG0480 228.86 Drug test def 1-7 classesG0481 313.18 Drug test def 8-14 classesG0482 397.48 Drug test def 15-21 classesG0483 493.84 Drug test def 22+ classesG0499 69.80 Hepb screen high risk indivG0659 143.66 Drug test def simple all clG9143 298.06 Warfarin respon genetic testP2028 12.22 Cephalin floculation testP2029 12.22 Congo red blood testP2031 12.22 Hair analysisP2033 12.22 Blood thymol turbidityP2038 12.22 Blood mucoproteinP3000 29.30 Screen pap by tech w md supvP9612 6.00 Catheterize for urine specP9615 6.00 Urine specimen collect multQ0111 29.30 Wet mounts/ w preparationsQ0112 11.66 Potassium hydroxide prepsQ0113 10.54 Pinworm examinationsQ0114 19.48 Fern testQ0115 50.00 Post-coital mucous exam