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National
2016 Laboratory Fee Schedule

Effective April 1, 2013 and while sequestration is in effect, all CMS payments for services will be reduced by 2%.
The fees below do not reflect this reduction. Click here for more information.



Disclaimer How To Use This Web Site Advance Beneficiary Notices Frequently Asked Questions
Index:

  • Blood Gases
  • Chemistry
  • Coagulation
  • Cardiac Markers
  • Pregnancy
  • Piccolo-Tests Performed by Waived Laboratories
  • Piccolo-Tests Performed by CLIA Moderate Complexity Laboratories
  • Cartridge: CHEM8+

    Test Performed Procedure Code Medicare Coverage National Limit
    All tests on Cartridge
    Basic Metabolic Panel (ionized Ca) 80047-QW
    Applicable
    CCI Edits
    $ 11.52
    Hematocrit 85014-QW
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 3.23
    Total Reimbursement = $ 14.75
    Single tests using "Test Select"
    Sodium 84295-QW
    $ 6.56
    Potassium 84132-QW
    $ 6.26
    Chloride 82435-QW
    $ 6.26
    TCO2 82374-QW
    $ 6.66
    Glucose 82947-QW
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 5.35
    Glucose post glucose dose 82950-QW
    Applicable
    CCI Edits
    $ 6.47
    Glucose tolerance test, 3 specimens, (includes glucose) 82951-QW
    Applicable
    CCI Edits
    $ 17.53
    Glucose tolerance test, each additional beyond 3 specimens 82952-QW
    Applicable
    CCI Edits
    $ 5.34
    Bun 84520-QW
    $ 5.38
    Creatinine 82565-QW
    $ 6.98
    Ionized Calcium 82330-QW
    $ 18.63
    Hematocrit 85014-QW
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 3.23
    Test combinations using "Test Select"
    Basic Metabolic Panel (ionized Ca) 80047-QW
    Applicable
    CCI Edits
    $ 11.52
    Electrolyte Panel 80051-QW
    Applicable
    CCI Edits
    $ 9.55
    BUN/Creatinine 84520-QW
    82565-QW
    2 Automated Tests $ 7.10
    Any 2 of the following tests:
    2 Automated Tests $ 7.10
    Any 3 of the following tests:
    3 Automated Tests $ 9.05
    Any 4 of the following tests:
    4 Automated Tests $ 9.55
    Any 5 of the following tests:
    5 Automated Tests $ 10.66
    Any 6 of the following tests:
    6 Automated Tests $ 10.68
    Any 7 of the following tests:
    7 Automated Tests $ 11.13
    Sodium, Potassium, Chloride TCO2, Glucose, BUN, Creatinine, Ionized Calcium

    Cartridge: ß-hCG
    Test Performed Procedure Code Medicare Coverage National Limit
    i-STAT Total ß-hCG 84702
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 20.51

    Cartridge: 6+
    Test Performed Procedure Code Medicare Coverage National Limit
    All tests on Cartridge
    Sodium 84295-QW
    Potassium 84132-QW
    Chloride 82435-QW
    Glucose 82947-QW
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    Bun 84520-QW
    5 Automated Tests $ 10.66
    Hematocrit 85014-QW
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 3.23
    Total Reimbursement = $ 13.89
    Single tests using "Test Select"
    Sodium 84295-QW
    $ 6.56
    Potassium 84132-QW
    $ 6.26
    Chloride 82435-QW
    $ 6.26
    Glucose 82947-QW
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 5.35
    BUN 84520-QW
    $ 5.38
    Hematocrit 85014-QW
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 3.23
    Test combinations using "Test Select"
    Any 2 of the following tests:
    2 Automated Tests $ 7.10
    Any 3 of the following tests:
    3 Automated Tests $ 9.05
    Any 4 of the following tests:
    4 Automated Tests $ 9.55
    All 5 of the following tests:
    5 Automated Tests $ 10.66
    Sodium, Potassium, Chloride Glucose, BUN

    Cartridge: EC8+
    Test Performed Procedure Code Medicare Coverage National Limit
    All tests on Cartridge
    Sodium 84295
    Potassium 84132
    Chloride 82435
    Glucose 82947
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    Bun 84520
    5 Automated Tests $ 10.66
    Hematocrit 85014
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 3.23
    pH, PCO2 82803
    Applicable
    CCI Edits
    $ 26.36
    Total Reimbursement = $ 40.25
    Single tests using "Test Select"
    Sodium 84295
    $ 6.56
    Potassium 84132
    $ 6.26
    Chloride 82435
    $ 6.26
    Glucose 82947
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 5.35
    Bun 84520
    $ 5.38
    Hematocrit 85014
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 3.23
    pH, PCO2 82803
    Applicable
    CCI Edits
    $ 26.36
    Test combinations using "Test Select"
    Any 2 of the following tests:
    2 Automated Tests $ 7.10
    Any 3 of the following tests:
    3 Automated Tests $ 9.05
    Any 4 of the following tests:
    4 Automated Tests $ 9.55
    All 5 of the following tests:
    5 Automated Tests $ 10.66
    Sodium, Potassium, Chloride Glucose, BUN

    Cartridge: Crea
    Test Performed Procedure Code Medicare Coverage National Limit
    Creatinine, Blood 82565-QW
    $ 6.98

    Cartridge: PT/INR
    Test Performed Procedure Code Medicare Coverage National Limit
    Prothrombin time 85610
    Applicable
    CCI Edits
    National
    Covered
    ICD-10 Codes
    $ 5.36


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