clinical diagnostic and pathology procedures...80322 alcohols levels 01/01/2018 13.27 14.74 80323...

Clinical Diagnosis | Pathology: of 25

Clinical Diagnostic and Pathology ProceduresEffective 07/22/2020

KEY FOR CURRENT/PREVIOUS MAXIMUM PAYMENT AMOUNTBR PAYMENT BY REPORTD DISCONTINUED PROCEDURE CODE

NC NON-COVERED SERVICE

HCPCS CODE

MODIFIER or COMPONENT

__ -- Total proc.26 -- Prof. comp.

TC -- Tech. comp.

DESCRIPTION EFFECTIVE DATE

CURRENT MAXIMUM PAYMENT AMOUNT

CURRENT MAXIMUM

NON-FACILITY PAYMENT AMOUNT

CURRENT MAXIMUM FACILITY PAYMENT AMOUNT

PREVIOUS MAXIMUM PAYMENT AMOUNT

PREVIOUS MAXIMUM


PREVIOUS MAXIMUM FACILITY PAYMENT AMOUNT

0202U Biofare respiratory panel 2.1 05/20/2020 347.320223U Nfct ds 22 trgt sars-cov-2 06/25/2020 347.320224U Antibody sars-cov-2 titer(s) 06/25/2020 42.1336415 Drawing blood 01/01/2018 2.25 2.9178267 Urea breath test 04/01/2019 8.30 8.0978268 Urea breath test, analysis 04/01/2019 70.81 69.3080047 Metabolic panel, ionized Ca 04/01/2019 10.30 7.5580048 Basic metabolic panel 04/01/2019 7.83 7.5580050 General Health Screen Panel 04/01/1998 NC80051 Electrolyte panel 04/01/2019 6.50 4.6580053 Comprehensive metabolic panel 04/01/2019 9.78 10.8780055 Obstetric Profile 04/01/2019 44.27 49.1980061 Lipid Panel 04/01/2019 12.40 13.0980069 Renal function panel 04/01/2019 8.04 8.9380074 Acute hepatitis panel 04/01/2019 44.11 46.8280076 Hepatic Function Panel 04/01/2019 7.57 6.5080081 Obstetric panel 04/01/2019 69.32 77.5080150 Amikacin 04/01/2019 13.96 15.5180155 Drug screen quant caffeine 04/01/2019 28.93 14.5580156 Carbamazepine 04/01/2019 13.49 14.9980157 Assay, carbamazepine, free 04/01/2019 12.27 12.6680158 Cyclosporine 04/01/2019 16.71 18.5780159 Drug screen quant clozapine 04/01/2019 17.12 19.0380162 Digoxin 04/01/2019 12.29 13.6680163 Digoxin level 04/01/2019 12.29 13.6680164 Dipropylacetic 04/01/2019 12.54 12.2180165 Valproic acid level 04/01/2019 12.54 9.9280168 Ethosuximide 04/01/2019 15.13 16.8180169 Drug screen quant everolimus 04/01/2019 12.72 14.1380170 Gentamicin 04/01/2019 15.17 16.8580171 Drug screen quant gabapentin 04/01/2019 16.25 13.6480173 Assay of haloperidol 04/01/2019 13.49 14.9980175 Drug screen quan lamotrigine 04/01/2019 12.27 13.6480176 Lidocaine 04/01/2019 13.61 15.1180177 Drug scrn quan levetiracetam 04/01/2019 12.27 13.6480178 Lithium 04/01/2019 6.12 6.8080180 Drug scrn quan mycophenolate 04/01/2019 16.71 18.5780183 Drug scrn quant oxcarbazepin 04/01/2019 12.27 13.6480184 Phenobarbital 04/01/2019 11.48 9.6580185 Phenytoin;Total 04/01/2019 12.27 13.6480186 Phenytion;Free 04/01/2019 12.74 14.1680188 Primidone 04/01/2019 15.36 17.0780190 Procainamide 04/01/2019 45.00 17.2480192 Procainamide;With Metabolites 04/01/2019 15.51 17.2480194 Quinidine 04/01/2019 13.52 15.0280195 Assay of sirolimus 04/01/2019 12.72 14.1380197 Tacrolimus 04/01/2019 12.72 14.1380198 Theophylline 04/01/2019 13.10 14.5580199 Drug screen quant tiagabine 04/01/2019 20.33 18.5880200 Tobrmycin 04/01/2019 14.93 16.5980201 Topiramate 04/01/2019 11.04 12.2680202 Vancomycin 04/01/2019 12.54 9.8680203 Drug screen quant zonisamide 04/01/2019 12.27 13.6480299 Quantitation Of Drugs,Nes 04/01/2019 13.98 10.8980305 Drug screen 04/01/2019 10.10 6.6780306 Drug screen 04/01/2019 13.47 8.8980307 Drug screen 04/01/2019 53.87 35.5680320 Alcohols levels 01/01/2018 13.27 14.7480321 Alcohols levels 01/01/2018 13.27 14.7480322 Alcohols levels 01/01/2018 13.27 14.7480323 Alkaloids levels 01/01/2018 9.95 11.0580324 Amphetamines levels 01/01/2018 10.61 11.7980325 Amphetamines levels 01/01/2018 10.61 11.7980326 Amphetamines levels 01/01/2018 10.61 11.7980327 Anabolic steroids levels 01/01/2018 10.61 11.7980328 Anabolic steroids levels 01/01/2018 10.61 11.7980329 Analgesics levels 01/01/2018 10.61 11.7980330 Analgesics levels 01/01/2018 10.61 11.7980331 Analgesics levels 01/01/2018 10.61 11.7980332 Antidepressants levels 01/01/2018 10.61 11.7980333 Antidepressants levels 01/01/2018 10.61 11.7980334 Antidepressants levels 01/01/2018 10.61 11.7980335 Antidepressants levels 01/01/2018 10.61 11.7980336 Antidepressants levels 01/01/2018 10.61 11.7980337 Antidepressants levels 01/01/2018 10.61 11.79




HCPCS CODE



TC -- Tech. comp.



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PREVIOUS MAXIMUM



80338 Antidepressants levels 01/01/2018 10.61 11.7980339 Antiepileptics levels 01/01/2018 10.61 11.7980340 Antiepileptics levels 01/01/2018 10.61 11.7980341 Antiepileptics levels 01/01/2018 10.61 11.7980342 Antipsychotics levels 01/01/2018 10.61 11.7980343 Antipsychotics levels 01/01/2018 10.61 11.7980344 Antipsychotics levels 01/01/2018 10.61 11.7980345 Barbiturates levels 01/01/2018 10.61 11.7980346 Benzodiazepines levels 01/01/2018 22.31 24.7980347 Benzodiazepines levels 01/01/2018 22.31 24.7980348 Buprenorphine level 01/01/2018 10.61 11.7980349 Cannabinoids levels 01/01/2018 10.61 11.7980350 Cannabinoids levels 01/01/2018 10.61 11.7980351 Cannabinoids levels 01/01/2018 10.61 11.7980352 Cannabinoids levels 01/01/2018 10.61 11.7980353 Drug screening cocaine 01/01/2018 10.61 11.7980354 Drug screening fentanyl 01/01/2018 10.61 11.7980355 Gabapentin non-blood 01/01/2018 10.61 11.7980356 Heroin metabolite 01/01/2018 10.61 11.7980357 Ketamine and norketamine 01/01/2018 10.61 11.7980358 Drug screening methadone 01/01/2018 10.61 11.7980359 Methylenedioxyamphetamines 01/01/2018 10.61 11.7980360 Methylphenidate 01/01/2018 10.61 11.7980361 Opiates 1 or more 01/01/2018 19.11 21.2380362 Opioids & opiate analogs 1/2 01/01/2018 19.11 21.2380363 Opioids & opiate analogs 3/4 01/01/2018 19.11 21.2380364 Opioid &opiate analog 5/more 01/01/2018 19.11 21.2380365 Drug screening oxycodone 01/01/2018 10.61 11.7980366 Drug screening pregabalin 01/01/2018 10.61 11.7980367 Drug screening propoxyphene 01/01/2018 10.61 11.7980368 Sedative hypnotics 01/01/2018 10.61 11.7980369 Skeletal muscle relaxant 1/2 01/01/2018 10.61 11.7980370 Skel musc relaxant 3 or more 01/01/2018 10.61 11.7980371 Stimulants synthetic 01/01/2018 10.61 11.7980372 Drug screening tapentadol 01/01/2018 10.61 11.7980373 Drug screening tramadol 01/01/2018 10.61 11.7980374 Stereoisomer analysis 01/01/2018 10.61 11.7980375 Drug/substance nos 1-3 01/01/2018 10.61 11.7980376 Drug/substance nos 4-6 01/01/2018 10.61 11.7980377 Drug/substance nos 7/more 01/01/2018 10.61 11.7980400 Acth Stimulation Panel 04/01/2019 30.20 33.5680402 Acth Stimulation Panel 04/01/2019 80.51 89.4680406 Acth Stimulation Panel 04/01/2019 72.47 80.5180408 Aldosterone Suppression Eval 04/01/2019 116.21 120.0380410 Calcium-Pentagastrin Stimul 04/01/2019 24.81 82.6680412 Crh Stimulation Panel 04/01/2019 601.22 339.1280414 Testosterone Response 04/01/2019 47.81 41.9280415 Estradiol Response Panel 04/01/2019 51.74 57.5080416 Renin stimulation panel 04/01/2019 156.99 108.5280417 Renin stimulation panel 04/01/2019 40.73 36.1880418 Pituitary Evaluation Panel 04/01/2019 536.57 596.2980420 Dexamethasone Panel 04/01/2019 121.41 74.1280422 Glucagon Tolerance Panel 04/01/2019 42.66 47.4080424 Glucagon Tolerance Panel 04/01/2019 46.76 51.9580426 Gonadotropin Hormone Panel 04/01/2019 137.42 152.6880428 Growth Hormone Panel 04/01/2019 61.76 68.6280430 Growth Hormone Panel 04/01/2019 97.00 80.7580432 Insulin Suppression Panel 04/01/2019 125.09 138.9980434 Insulin Tolerance Panel 04/01/2019 213.77 104.0980435 Insulin Tolerance Panel 04/01/2019 95.39 105.9880436 Metyrapone Panel 04/01/2019 84.41 93.7980438 Trh Stimulation Panel 04/01/2019 46.68 51.8680439 Trh Stimulation Panel 04/01/2019 62.24 69.1580500 Clinical Pathology Consultation 04/01/2019 17.12 14.64 13.22 10.0680502 Clinical Pathology Consultation 04/01/2019 54.78 52.80 49.35 45.0581000 Urinalysis,Reagent Strips With Microscop 04/01/2019 3.02 3.2681001 Urinalysis, auto, w/scope 04/01/2019 2.94 3.2681002 Urinalysis Routine Wo.Microscopy,Nonauto 04/01/2019 2.61 2.4281003 Urinalysis Routine Wo Microscopy,Automat 04/01/2019 2.08 2.3181005 Urinalysis Qual/Semi Not Immunoassay 04/01/2019 2.00 2.2381007 Urinalysis;Bacteria Screen,Non-Cult,Kit 04/01/2019 22.49 2.6481015 Urinalysis Microscopic 04/01/2019 2.82 3.1481020 Urinalysis, glass test 04/01/2019 3.53 3.8081025 Urine Preg Test,Visual Color Comparison 04/01/2019 6.46 6.5081050 Volume Measurement,Time Collect,Each 04/01/2019 2.78 3.0981099 Unlisted Urinalysis Procedure 01/01/2018 3.82 4.2481105 HPA-1 GENOTYPING 04/01/2019 101.85 125.7581106 HPA-2 GENOTYPING 04/01/2019 101.85 125.7581107 HPA-3 GENOTYPING 04/01/2019 101.85 125.75




HCPCS CODE



TC -- Tech. comp.



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81108 HPA-4 GENOTYPING 04/01/2019 101.85 125.7581109 HPA-5 GENOTYPING 04/01/2019 101.85 125.7581110 HPA-6 GENOTYPING 04/01/2019 101.85 125.7581111 HPA-9 GENOTYPING 04/01/2019 101.85 125.7581112 HPA-15 GENOTYPING 04/01/2019 101.85 125.7581120 IDH1 COMMON VARIANTS 04/01/2019 144.94 148.9381121 IDH2 COMMON VARIANTS 04/01/2019 221.84 223.4081162 Brca1&2 seq & full dup/del 04/01/2019 1,689.70 1,877.4581163 Brca1&2 gene full seq alys 04/01/2019 351.00 BR81164 Brca1&2 gen ful dup/del alys 04/01/2019 438.17 BR81165 Brca1 gene full seq alys 04/01/2019 212.16 BR81166 Brca1 gene full dup/del alys 04/01/2019 226.01 BR81167 Brca2 gene full dup/del alys 04/01/2019 212.16 BR81170 Abl1 gene 04/01/2019 225.00 248.8781171 Aff2 gene detc abnor alleles 04/01/2019 102.75 BR81172 Aff2 gene charac alleles 04/01/2019 206.12 BR81173 Ar gene full gene sequence 04/01/2019 226.01 BR81174 Ar gene known famil variant 04/01/2019 138.90 BR81175 ASXL1 FULL GENE SEQUENCE 04/01/2019 530.27 589.1981176 ASXL1 GENE TARGET SEQ ALYS 04/01/2019 223.98 248.8781177 Atn1 gene detc abnor alleles 04/01/2019 102.75 BR81178 Atxn1 gene detc abnor allele 04/01/2019 102.75 BR81179 Atxn2 gene detc abnor allele 04/01/2019 102.75 BR81180 Atxn3 gene detc abnor allele 04/01/2019 102.75 BR81181 Atxn7 gene detc abnor allele 04/01/2019 102.75 BR81182 Atxn8os gen detc abnor allel 04/01/2019 102.75 BR81183 Atxn10 gene detc abnor allel 04/01/2019 102.75 BR81184 Cacna1a gen detc abnor allel 04/01/2019 102.75 BR81185 Cacna1a gene full gene seq 04/01/2019 634.70 BR81186 Cacna1a gen known famil vrnt 04/01/2019 138.90 BR81187 Cnbp gene detc abnor allele 04/01/2019 102.75 BR81188 Cstb gene detc abnor allele 04/01/2019 102.75 BR81189 Cstb gene full gene sequence 04/01/2019 206.12 BR81190 Cstb gene known famil vrnt 04/01/2019 138.90 BR81200 Aspa gene 04/01/2019 35.44 67.5081201 Apc gene full sequence 04/01/2019 585.00 90.0081202 Apc gene known fam variants 04/01/2019 210.00 67.5081203 Apc gene dup/delet variants 04/01/2019 150.00 90.0081204 Ar gene charac alleles 04/01/2019 102.75 BR81205 Bckdhb gene 04/01/2019 71.24 90.0081206 Bcr/abl1 gene major bp 04/01/2019 151.82 168.6881207 Bcr/abl1 gene minor bp 04/01/2019 134.11 149.0181208 Bcr/abl1 gene other bp 04/01/2019 160.97 165.4781209 Blm gene 04/01/2019 29.48 40.5081210 Braf gene 04/01/2019 131.55 135.1781211 BRCA1&2 seq & com dup/del 01/01/2019 NC 1,655.3181212 Brca1&2 185&5385&6174 var 04/01/2019 330.00 133.0081213 Brca1&2 uncom dup/del var 01/01/2019 NC 439.4381214 Brca1 full seq & com dup/del 01/01/2019 NC 1,084.5181215 Brca1 gene known fam variant 04/01/2019 281.44 70.3181216 Brca2 gene full sequence 04/01/2019 138.84 864.0081217 Brca2 gene known fam variant 04/01/2019 281.44 70.3181218 Cebpa gene full sequence 04/01/2019 223.98 248.8781219 Calr gene com variants 04/01/2019 112.62 125.1381220 Cftr gene com variants 04/01/2019 417.45 576.0081221 Cftr gene known fam variants 04/01/2019 72.92 67.5081222 Cftr gene dup/delet variants 04/01/2019 326.30 90.0081223 Cftr gene full sequence 04/01/2019 374.25 864.0081224 Cftr gene intron poly t 04/01/2019 126.56 58.5081225 Cyp2c19 gene com variants 04/01/2019 218.52 220.0581226 Cyp2d6 gene com variants 04/01/2019 338.18 340.5581227 Cyp2c9 gene com variants 04/01/2019 131.11 132.0281228 Cytogen micrarray copy nmbr 04/01/2019 675.00 90.0081229 Cytogen m array copy no&snp 04/01/2019 870.00 486.0081230 CYP3A4 GENE COMMON VARIANTS 04/01/2019 131.11 132.0281231 CYP3A5 GENE COMMON VARIANTS 04/01/2019 131.11 132.0281232 DPYD GENE COMMON VARIANTS 04/01/2019 131.11 132.0281233 Btk gene common variants 04/01/2019 131.55 BR81234 Dmpk gene detc abnor allele 04/01/2019 102.75 BR81235 Egfr gene com variants 04/01/2019 243.44 248.8781236 Ezh2 gene full gene sequence 04/01/2019 212.16 BR81237 Ezh2 gene common variants 04/01/2019 131.55 BR81238 F9 FULL GENE SEQUENCE 04/01/2019 450.00 453.0081239 Dmpk gene charac alleles 04/01/2019 206.12 BR81240 F2 gene 04/01/2019 49.27 50.6381241 F5 gene 04/01/2019 56.58 62.8781242 Fancc gene 04/01/2019 27.47 58.5081243 Fmr1 gene detection 04/01/2019 42.78 45.0081244 Fmr1 gene characterization 04/01/2019 33.67 72.00




HCPCS CODE



TC -- Tech. comp.



CURRENT MAXIMUM




PREVIOUS MAXIMUM



81245 Flt3 gene 04/01/2019 124.13 125.1381246 Flt3 gene analysis 04/01/2019 62.25 62.7281247 G6PD GENE ALYS CMN VARIANT 04/01/2019 131.11 132.0281248 G6PD KNOWN FAMILIAL VARIANT 04/01/2019 281.44 70.3181249 G6PD FULL GENE SEQUENCE 04/01/2019 450.00 453.0081250 G6pc gene 04/01/2019 43.87 67.5081251 Gba gene 04/01/2019 35.44 67.5081252 Gjb2 gene full sequence 04/01/2019 75.84 90.0081253 Gjb2 gene known fam variants 04/01/2019 46.14 49.5081254 Gjb6 gene com variants 04/01/2019 26.25 27.0081255 Hexa gene 04/01/2019 38.59 67.5081256 Hfe gene 04/01/2019 60.52 67.2581257 Hba1/hba2 gene 04/01/2019 76.70 130.5081258 HBA1/HBA2 GENE FAM VRNT 04/01/2019 281.44 70.3181259 HBA1/HBA2 FULL GENE SEQUENCE 04/01/2019 450.00 453.0081260 Ikbkap gene 04/01/2019 29.48 67.5081261 Igh gene rearrange amp meth 04/01/2019 183.32 203.6981262 Igh gene rearrang dir probe 04/01/2019 51.41 44.9181263 Igh vari regional mutation 04/01/2019 272.70 303.0081264 Igk rearrangeabn clonal pop 04/01/2019 138.26 153.6281265 Str markers specimen anal 04/01/2019 199.12 221.2481266 Str markers spec anal addl 04/01/2019 228.61 90.0081267 Chimerism anal no cell selec 04/01/2019 192.09 213.4481268 Chimerism anal w/cell select 04/01/2019 241.47 268.3081269 HBA1/HBA2 GENE DUP/DEL VRNTS 04/01/2019 151.80 143.7981270 Jak2 gene 04/01/2019 84.88 94.3181271 Htt gene detc abnor alleles 04/01/2019 102.75 BR81272 Kit gene targeted seq analys 04/01/2019 247.13 248.8781273 Kit gene analys d816 variant 04/01/2019 93.65 70.2281274 Htt gene charac alleles 04/01/2019 206.12 BR81275 Kras gene 04/01/2019 144.94 148.9381276 Kras gene addl variants 04/01/2019 144.94 148.9381283 IFNL3 GENE 04/01/2019 55.03 56.5881284 Fxn gene detc abnor alleles 04/01/2019 102.75 BR81285 Fxn gene charac alleles 04/01/2019 206.12 BR81286 Fxn gene full gene sequence 04/01/2019 206.12 BR81287 Mgmt gene methylation anal 04/01/2019 93.48 62.7581288 Mlh1 gene 04/01/2019 144.24 120.5781289 Fxn gene known famil variant 04/01/2019 138.90 BR81290 Mcoln1 gene 04/01/2019 29.48 67.5081291 Mthfr gene 04/01/2019 49.01 44.9181292 Mlh1 gene full seq 04/01/2019 506.55 487.3481293 Mlh1 gene known variants 04/01/2019 248.25 195.3681294 Mlh1 gene dup/delete variant 04/01/2019 151.80 143.7981295 Msh2 gene full seq 04/01/2019 286.28 114.4181296 Msh2 gene known variants 04/01/2019 253.30 97.6981297 Msh2 gene dup/delete variant 04/01/2019 159.98 114.4181298 Msh6 gene full seq 04/01/2019 481.39 217.0681299 Msh6 gene known variants 04/01/2019 231.00 121.6081300 Msh6 gene dup/delete variant 04/01/2019 178.50 121.9381301 Microsatellite instability 04/01/2019 268.11 297.9081302 Mecp2 gene full seq 04/01/2019 395.90 90.0081303 Mecp2 gene known variant 04/01/2019 90.00 85.5081304 Mecp2 gene dup/delet variant 04/01/2019 112.50 58.5081305 Myd88 gene p.leu265pro vrnt 04/01/2019 131.55 BR81306 Nudt15 gene common variants 04/01/2019 218.52 BR81310 Npm1 gene 04/01/2019 184.89 186.3881311 Nras gene variants exon 2&3 04/01/2019 221.84 223.4081312 Pabpn1 gene detc abnor allel 04/01/2019 102.75 BR81313 PCA3/KLK3 Antigen 04/01/2019 191.29 196.5681314 Pdgfra gene 04/01/2019 247.13 248.8781315 Pml/raralpha com breakpoints 04/01/2019 191.96 213.2981316 Pml/raralpha 1 breakpoint 04/01/2019 191.96 325.3281317 Pms2 gene full seq analysis 04/01/2019 530.27 589.1981318 Pms2 known familial variants 04/01/2019 248.25 139.2281319 Pms2 gene dup/delet variants 04/01/2019 152.63 167.1681320 Plcg2 gene common variants 04/01/2019 218.52 BR81321 Pten gene full sequence 04/01/2019 450.00 453.0081322 Pten gene known fam variant 04/01/2019 39.64 42.7581323 Pten gene dup/delet variant 04/01/2019 225.00 66.5081324 Pmp22 gene dup/delet 04/01/2019 568.77 90.0081325 Pmp22 gene full sequence 04/01/2019 577.19 90.0081326 Pmp22 gene known fam variant 04/01/2019 39.64 67.5081327 Sept9 methylation analysis 04/01/2019 144.00 62.7581328 SLCO1B1 GENE COM VARIANTS 04/01/2019 131.11 132.0281329 Smn1 gene dos/deletion alys 04/01/2019 102.75 BR81330 Smpd1 gene common variants 04/01/2019 35.25 67.5081331 Snrpn/ube3a gene 04/01/2019 38.30 36.0081332 Serpina1 gene 04/01/2019 36.38 44.91




HCPCS CODE



TC -- Tech. comp.



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PREVIOUS MAXIMUM



81333 Tgfbi gene common variants 04/01/2019 102.75 BR81334 RUNX1 GENE TARGETED SEQ ALYS 04/01/2019 494.27 248.8781335 TPMT GENE COM VARIANTS 04/01/2019 131.11 132.0281336 Smn1 gene full gene sequence 04/01/2019 226.01 BR81337 Smn1 gen nown famil seq vrnt 04/01/2019 138.90 BR81340 Trb@ gene rearrange amplify 04/01/2019 193.44 214.9481341 Trb@ gene rearrange dirprobe 04/01/2019 45.92 51.0181342 Trg gene rearrangement anal 04/01/2019 186.57 207.3081343 Ppp2r2b gen detc abnor allel 04/01/2019 102.75 BR81344 Tbp gene detc abnor alleles 04/01/2019 102.75 BR81345 Tert gene targeted seq alys 04/01/2019 138.90 BR81346 TYMS GENE COM VARIANTS 04/01/2019 131.11 132.0281350 Ugt1a1 gene 04/01/2019 175.50 40.5081355 Vkorc1 gene 04/01/2019 66.15 58.5081361 HBB GENE COM VARIANTS 04/01/2019 131.11 132.0281362 HBB GENE KNOWN FAM VARIANT 04/01/2019 281.44 70.3181363 HBB GENE DUP/DEL VARIANTS 04/01/2019 151.80 143.7981364 HBB FULL GENE SEQUENCE 04/01/2019 243.44 248.8781370 Hla i & ii typing lr 04/01/2019 372.34 413.7181371 Hla i & ii type verify lr 04/01/2019 303.39 247.6381372 Hla i typing complete lr 04/01/2019 302.69 227.2781373 Hla i typing 1 locus lr 04/01/2019 103.11 114.5781374 Hla i typing 1 antigen lr 04/01/2019 67.36 74.8481375 Hla ii typing ag equiv lr 04/01/2019 204.39 227.1081376 Hla ii typing 1 locus lr 04/01/2019 101.85 125.7581377 Hla ii type 1 ag equiv lr 04/01/2019 85.01 94.4681378 Hla i & ii typing hr 04/01/2019 319.97 355.5281379 Hla i typing complete hr 04/01/2019 310.54 345.0581380 Hla i typing 1 locus hr 04/01/2019 164.12 182.3681381 Hla i typing 1 allele hr 04/01/2019 127.43 97.3181382 Hla ii typing 1 loc hr 04/01/2019 114.52 127.2581383 Hla ii typing 1 allele hr 04/01/2019 101.05 112.2881400 Mopath procedure level 1 04/01/2019 47.97 63.0081401 Mopath procedure level 2 04/01/2019 102.75 72.0081402 Mopath procedure level 3 04/01/2019 112.75 121.5081403 Mopath procedure level 4 04/01/2019 138.90 171.0081404 Mopath procedure level 5 04/01/2019 206.12 216.0081405 Mopath procedure level 6 04/01/2019 226.01 324.0081406 Mopath procedure level 7 04/01/2019 212.16 468.0081407 Mopath procedure level 8 04/01/2019 634.70 864.0081408 Mopath procedure level 9 04/01/2019 1,500.00 1,579.5081410 Aortic dysfunction/dilation 04/01/2019 378.00 324.0081411 Aortic dysfunction/dilation 04/01/2019 1,012.64 324.0081412 Ashkenazi jewish assoc dis 04/01/2019 1,836.42 451.5881413 Car ion chnnlpath inc 10 gns 04/01/2019 541.58 601.7581414 Car ion chnnlpath inc 2 gns 04/01/2019 541.58 601.7581415 Exome sequence analysis 04/01/2019 3,585.00 171.0081416 Exome sequence analysis 04/01/2019 9,000.00 121.5081417 Exome re-evaluation 04/01/2019 240.00 72.0081420 Fetal chrmoml aneuploidy 04/01/2019 569.29 601.7581422 Fetal chrmoml microdeltj 04/01/2019 569.29 601.7581425 Genome sequence analysis 04/01/2019 3,773.40 171.0081426 Genome sequence analysis 04/01/2019 2,032.46 121.5081427 Genome re-evaluation 04/01/2019 1,753.24 72.0081430 Hearing loss sequence analys 04/01/2019 1,218.75 864.0081431 Hearing loss dup/del analys 04/01/2019 509.68 72.0081432 Hrdtry brst ca-rlatd dsordrs 04/01/2019 628.75 698.6181433 Hrdtry brst ca-rlatd dsordrs 04/01/2019 406.42 451.5881434 Hereditary retinal disorders 04/01/2019 448.43 451.5881435 Hereditary colon cancer 04/01/2019 541.58 601.7581436 Hereditary colon ca synd 04/01/2019 541.58 601.7581437 Heredtry nurondcrn tum dsrdr 04/01/2019 406.42 342.0081438 Heredtry nurondcrn tum dsrdr 04/01/2019 406.42 342.0081439 Inherited cardmypthy 5 gns 04/01/2019 541.58 601.7581440 Mitochondrial gene 04/01/2019 2,493.00 324.0081442 Noonan spectrum disorders 04/01/2019 1,607.70 451.5881443 Genetic tstg severe inh cond 04/01/2019 1,836.42 BR81445 Targeted genomic seq analys 04/01/2019 448.43 451.5881448 HRDTRY PERPH NEURPHY PANEL 04/01/2019 487.42 601.7581450 Targeted genomic seq analys 04/01/2019 569.65 489.7181455 Targeted genomic seq analys 04/01/2019 2,189.70 468.0081460 Whole mitochondrial genome 04/01/2019 965.25 72.0081465 Whole mitochondrial genome 04/01/2019 702.00 216.0081470 X-linked intellectual dblt 04/01/2019 685.50 468.0081471 X-linked intellectual dblt 04/01/2019 685.50 72.0081479 Unlisted molecular pathology 01/01/2018 90.00 100.0081490 Autoimmune rheumatoid arthr 01/01/2016 NC81493 Cor artery disease mrna 01/01/2016 NC81500 Onco (ovar) two proteins 01/01/2013 NC




HCPCS CODE



TC -- Tech. comp.



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81503 Onco (ovar) five proteins 01/01/2013 NC81504 Oncology tissue of origin 01/01/2014 NC81506 Endo assay seven anal 01/01/2013 NC81507 Fetal aneuploidy trisom risk 04/01/2019 596.25 NC81508 Ftl cgen abnor two proteins 01/01/2013 NC81509 Ftl cgen abnor 3 proteins 01/01/2013 NC81510 Ftl cgen abnor three anal 01/01/2013 NC81511 Ftl cgen abnor four anal 01/01/2013 NC81512 Ftl cgen abnor five anal 01/01/2013 NC81518 Onc brst mrna 11 genes 04/01/2019 2,904.75 BR81519 Oncology breast mrna 04/01/2019 2,904.75 2,598.2581520 ONC BREAST MRNA 58 GENES 04/01/2019 2,091.84 2,582.5281521 ONC BREAST MRNA 70 GENES 04/01/2019 2,904.75 2,598.2581525 Oncology colon mrna 01/01/2016 NC81528 Oncology colorectal scr 04/01/2019 381.65 384.3281535 Oncology gynecologic 01/01/2016 NC81536 Oncology gynecologic 01/01/2016 NC81538 Oncology lung 01/01/2016 NC81539 Oncology prostate prob score 04/01/2019 570.00 451.5881540 Oncology tum unknown origin 01/01/2016 NC81541 ONC PROSTATE MRNA 46 GENES 04/01/2019 2,904.75 2,598.2581545 Oncology thyroid 01/01/2016 NC81551 ONC PROSTATE 3 GENES 04/01/2019 1,522.50 BR81595 Cardiology hrt trnspl mrna 01/01/2016 NC81596 Nfct ds chrnc hcv 6 assays 04/01/2019 54.14 BR81599 Unlisted maaa 04/01/2017 BR NC82009 Acetone Or Other Ketones Qualitative 04/01/2019 4.19 3.5282010 Acetone Or Other Ketones Quantitative 04/01/2019 7.57 7.8282013 Acetylcholinesterase 04/01/2019 10.34 11.4982016 Acylcarnitines; qualitative, each specimen 04/01/2019 12.85 14.2782017 Acylcarnitines; quantitative, each specimen 04/01/2019 15.62 17.3682024 Adrenocorticotrophic Hormone (Acth) Ria 04/01/2019 35.76 39.7482030 Adenosine; 5-Monophosp 04/01/2019 21.50 26.5482040 Albumin; Serum 04/01/2019 4.58 5.0982042 Albumin, Urine, Quantitative 04/01/2019 5.84 5.3382043 Urine,Microalbumin,Quant 04/01/2019 5.36 5.9582044 Urine,Microalbumin;Semiquantitative 04/01/2019 4.67 4.7182045 Albumin, ischemia modified 04/01/2019 28.28 34.9282075 Alcohol,(Ethanol) Breath 04/01/2019 22.50 11.8882085 Aldolase 04/01/2019 8.09 9.9982088 Aldosterone 04/01/2019 37.73 41.9382103 Alpha-1- Antitrypsin;Total 04/01/2019 11.20 13.8282104 Alpha-1-Antitrypsin;Phenotype 04/01/2019 12.05 14.8882105 Alpha-Fetoprotein;Serum 04/01/2019 13.98 17.2682106 Alpha-Fetoprotein,Amniotic Fluid 04/01/2019 13.98 17.2682107 Alpha-fetoprotein l3 04/01/2019 59.64 66.2782108 Aluminum 04/01/2019 21.23 26.2182120 Amines, vaginal fluid, qualitative 04/01/2019 4.49 3.8882127 Amino Acids; single. qualitative, each 04/01/2019 11.56 14.2782128 Amino Acids Qualitative 04/01/2019 11.56 14.2782131 Amino Acids,Frac/Quant,Each 04/01/2019 17.24 17.3682135 Aminolevulinic Acid Delta (Ala) 04/01/2019 15.23 15.7182136 Amino Acids; 2 to 5, quant., each 04/01/2019 15.62 17.3682139 Amino Acids; 6 or more, quant., each 04/01/2019 14.06 17.3682140 Ammonia 04/01/2019 13.49 14.9982142 Ammonium Chloride Loading Test 01/01/1995 NC82143 Amniotic Fluid Acan (Spectrophotometric) 04/01/2019 7.01 7.0682150 Amylase 04/01/2019 6.00 6.6782154 Androstanediol Glucuronide 04/01/2019 26.70 29.6682157 Androstenedione 04/01/2019 27.11 30.1282160 Androsterone 04/01/2019 23.15 25.7282163 Angiotensin Ii 04/01/2019 17.10 21.1182164 Angiotension-Converting Enzyme (Ace) 04/01/2019 13.52 15.0282172 Apolipoprotein Each 04/01/2019 15.82 15.9582175 Arsenic 04/01/2019 15.81 15.7182180 Ascorbic Acid (Vitamin C),Blood 04/01/2019 8.24 10.1782190 Atomic Absorption Spectro,Ea Analyte 04/01/2019 12.42 15.3382232 Beta-2 Microglobulin 04/01/2019 13.48 14.9382239 Bile Acids, Total 04/01/2019 15.86 17.6282240 Bile Acids; Cholyglycine 04/01/2019 24.61 27.3582247 Bilirubin; total 04/01/2019 4.18 4.1682248 Bilirubin; direct 04/01/2019 4.18 4.1682252 Bilirubin,Feces,Qualitative 04/01/2019 3.80 4.6882261 Biotinidase, each specimen 04/01/2019 14.06 17.3682270 Blood Occult Feces Screening 04/01/2019 3.29 3.3582271 Occult blood, feces, single 04/01/2019 3.99 3.3582272 Blood occult peroxidase 04/01/2019 3.17 3.3582274 Fecal hemoglobin immunoassy test 04/01/2019 14.73 16.3782286 Bradykinin 04/01/2019 4.30 7.09




HCPCS CODE



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82300 Cadmium 04/01/2019 19.29 23.8182306 Vitamin D, 25 hydroxy 04/01/2019 24.67 30.4682308 Calcitonin 04/01/2019 22.33 27.5682310 Calcium; Total 04/01/2019 4.78 5.3182330 Calcium; Ionized 04/01/2019 12.66 14.0782331 Calcium, After Calcium Infusion Test 04/01/2019 10.01 5.3282335 Calcium Urin Qualitative Sulkowitch 04/01/2001 NC82340 Calcium Urin Quant, Times Spec 04/01/2019 5.03 6.2082355 Calculus Stone Qualitative Chemical 04/01/2019 9.65 8.9982360 Calculus Stone Quantitative Chemical 04/01/2019 10.73 11.9882365 Calculus Infrared, Spectroscopy 04/01/2019 10.75 13.2782370 Calculus X-Ray Diffraction 04/01/2019 10.44 11.9882373 Assay, c-d transfer measure 04/01/2019 15.05 18.5882374 Carbon Dioxide (Bicarbonate) 04/01/2019 4.52 5.0382375 Carbon Monoxide Quantitative 04/01/2019 10.27 11.9882376 Carbon Monoxide Qualitative 04/01/2019 10.55 6.1682378 Carcinoembryonic Antigen (Cea) 04/01/2019 15.80 19.5182379 Carnitine (total & free); quant., each 04/01/2019 14.06 17.3682380 Carotene 04/01/2019 7.69 9.4982382 Catecholamines; Total Urine 04/01/2019 20.48 17.6982383 Catecholamines; Blood 04/01/2019 23.20 25.7882384 Catecholamines Fractionated 04/01/2019 21.05 25.9882387 Cathepsin-D 04/01/2019 15.05 21.4182390 Ceruloplasmin 04/01/2019 8.95 11.0582397 Chemliuminescent 04/01/2019 11.77 14.5382415 Chloramphenicol 04/01/2019 10.56 13.0482435 Chlorides; Blood 04/01/2019 4.26 4.7382436 Chlorides; Urine 04/01/2019 4.31 5.1882438 Chloride; Spinal Fluid 04/01/2019 4.07 5.0382441 Chlorinated Hydrocarbons, Screen 04/01/2019 5.57 6.1882465 Chloesterol, Serum, Total 04/01/2019 4.03 4.4882480 Cholinesterase; Serum 04/01/2019 6.56 8.1082482 Cholinesterase; Rbc 04/01/2019 7.36 7.9082485 Chondroitin B Sulfate, Quantitative 04/01/2019 17.21 21.2582495 Chromium 04/01/2019 16.90 20.8782507 Citrate 04/01/2019 23.17 28.6182523 Collagen cross links, any method 04/01/2019 15.57 19.2282525 Copper 04/01/2019 10.34 12.7782528 Corticosterone 04/01/2019 18.77 23.1782530 Cortisol; Free 04/01/2019 13.93 17.1982533 Cortisol; Total 04/01/2019 13.58 16.7782540 Creatine 04/01/2019 4.29 4.7082542 Column chromatography/mass spectrometry 04/01/2019 18.07 18.5882550 Creatinekinase (Ck),(Cpk);Total 04/01/2019 6.03 6.7082552 Creatinekinase (Ck) (Cpk);Isoenzymes 04/01/2019 11.16 13.7882553 Creatinine Kinase (Cpk);Mb Fraction 04/01/2019 9.62 9.3682554 Creatinine Kinase (Cpk);Isoforms 04/01/2019 9.89 12.2182565 Creatinine Kinase (Ck) (Cpk);Isoforms 04/01/2019 4.75 5.2782570 Creatinine Urine 04/01/2019 4.79 5.3382575 Creatinine Clearance 04/01/2019 7.88 9.7382585 Cryofibrinogen 04/01/2019 10.61 4.1382595 Cryoglobulin 04/01/2019 5.39 6.6582600 Cyanide 04/01/2019 16.16 19.7182607 Cyanocobalamin (Vitamin B12); 04/01/2019 12.56 15.5182608 Cyamocobalamin;Unsaturated Binding Cap. 04/01/2019 11.93 14.7382610 Cystatin C 04/01/2019 13.89 13.9982615 Cystine And Homocystine Urine Qualitativ 04/01/2019 7.56 7.6482626 Dehydroepiandrosterone (Dhea) 04/01/2019 21.06 26.0082627 Dehydropiandrosterone-Sulfate (Dhea-S) 04/01/2019 18.53 22.8882633 Desoxycorticosterone 11 04/01/2019 25.82 31.8882634 Desoxycorticosol 11 04/01/2019 24.40 30.1282638 Dibucaine Number 04/01/2019 10.21 12.6082642 Dihydrotestosterone 04/01/2019 24.40 BR82652 Vit D, 25-dihydroxy 04/01/2019 32.09 39.6182656 Pancreatic elastase, fecal 04/01/2019 9.61 11.8782657 Enzyme activity in blood cells 04/01/2019 16.63 18.5882658 Enzyme activity in blood cells 04/01/2019 33.02 18.5882664 Electrophoretic Technique Nos 04/01/2019 46.13 35.3482668 Erythropoietin 04/01/2019 15.66 19.3482670 Estradiol 04/01/2019 23.28 28.7482671 Estrogens; Fractionated 04/01/2019 26.92 33.2382672 Estrogens; Total 04/01/2019 18.08 22.3282677 Estriol 04/01/2019 22.39 24.8882679 Estrone 04/01/2019 23.11 20.9682693 Ethylene Gylcol 04/01/2019 12.42 15.3382696 Etiocholanolone 04/01/2019 19.68 24.2682705 Fat Or Lipids Feces, Qual 04/01/2019 4.25 1.6182710 Fat/Lipids Feces, Quant 04/01/2019 14.00 17.2982715 Fat Differential,Feces, Quantitative 04/01/2019 17.23 17.71




HCPCS CODE



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82725 Fatty Acids, Non Esterified 04/01/2019 14.08 13.7082726 Very long chain fatty acids 04/01/2019 15.05 18.5882728 Ferritin 04/01/2019 11.36 14.0382731 Fetal fibronectin 04/01/2019 53.68 66.2782735 Floride 04/01/2019 15.45 19.0782746 Folic Acid; Serum 04/01/2019 12.26 15.1382747 Folic Acid;Rbs 04/01/2019 14.44 17.8282757 Fructose, Semen 04/01/2019 14.45 2.4182759 Galactokinase Rbc 04/01/2019 17.90 11.8882760 Galactose 04/01/2019 9.33 11.5282775 Galactose-1-Phosph Uridyl Trans Quantit 04/01/2019 17.56 21.6882776 Galactose-1-Phosph Uridyl Trans Screen 04/01/2019 8.81 8.6382777 Galectin 3 04/01/2019 33.19 16.9182784 Gammaglobulin A D G M Each 04/01/2019 7.76 9.5782785 Gammaglobulin Ige 04/01/2019 13.72 16.9482787 Gammaglobulin;Subclasses Igg 04/01/2019 6.68 8.2582800 Gases, Blood; Ph Only 04/01/2019 8.25 8.7182803 Gases Blood Ph Pc02 By Simultaneous 04/01/2019 19.55 19.9182805 Blood Gases W/02 Saturation 04/01/2019 59.08 27.9682810 Blood Gases 02 Sat Only 04/01/2019 7.33 8.4682820 Hemoglobin-02 Affinity 04/01/2019 10.01 9.4482927 Gastric Acid Free And Total Ea Add Spec 04/01/2001 NC82930 Gastric acid analyis w/ph ea specimen 04/01/2019 5.04 5.6082938 Gastrin After Secretin Stimulation 04/01/2019 14.75 18.2082941 Gastrin 04/01/2019 14.69 18.1482943 Glucagon 04/01/2019 11.91 14.7082945 Glucose other fluid 04/01/2019 3.28 4.0482946 Glucagon Tolerance Test 04/01/2019 13.33 13.0182947 Glucose; Quantitative 04/01/2019 3.28 4.0482948 Glucose; Blood, Reagent Strip 04/01/2019 3.78 3.2682950 Glucose;Post Glucose Dose Include Glucos 04/01/2019 4.40 4.8882951 Gtt 3 Specimens (Includes Glucose) 04/01/2019 11.92 10.0682952 Glucose Tolerance Test >3 Specim Ea Sp 04/01/2019 3.63 3.9282955 Glucose-6-Phosph Dehydrogenase Quantit 04/01/2019 8.98 4.6982960 Glucose-6-Phosph Dehydrogenase Screen 04/01/2019 5.60 6.2382962 Glucose, Clia Waived Methodology 04/01/2019 2.46 2.4182963 Glucosidase, Beta 04/01/2019 17.90 4.6982965 Glutamate Dehydrogenase 04/01/2019 9.86 4.6982977 Glutamyltransferase, Gamma (Gtt) 04/01/2019 6.67 7.4182978 Glutathione 04/01/2019 11.88 12.7482979 Glutathione Reductase Rbc 04/01/2019 8.75 7.0982985 Glycated Protein 04/01/2019 13.96 5.4583001 Gonadotropin; Fsh 04/01/2019 17.21 19.1283002 Gonadotropin; Luteinzing Hormone (Lh) 04/01/2019 17.15 19.0583003 Growth Hormone(Hgh) Somatotropin 04/01/2019 13.89 17.1583006 Growth stimulation gene 2 04/01/2019 56.70 18.0983009 H pylori (c-13), blood 04/01/2019 56.13 69.3083010 Haptoglobin; Quantitative 04/01/2019 10.48 12.9483012 Haptoglobin; Phenotypes 04/01/2019 20.17 16.7583013 Helicobacter pylori, breath test analysis 04/01/2019 56.13 69.3083014 Helicobacter pylori; drug admin. & sample coll. 04/01/2019 6.55 8.0983015 Heavy Metal; Screen Arsenic Bism, Etc. 04/01/2019 15.71 13.1383018 Heavy Metal; Quantitative, Each 04/01/2019 18.31 22.6083020 Hemoglobin fraction & quant; electrophoresis 04/01/2019 10.73 13.2583020 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6983021 Hemoglobin fractionation & quantitation 04/01/2019 15.05 18.5883026 Hemoglobin;By Coper Sulfate Method 04/01/2019 3.01 2.4383030 Hemoglobin; F Fetal Chemical 04/01/2019 8.06 7.8583033 Hemoglobin F Fetal Qualitatat Apt Fecal 04/01/2019 6.00 7.9983036 Hemoglobin; Glycated 04/01/2019 8.99 9.9983037 Glycosylated hb, home device 04/01/2019 8.99 9.9983045 Hemoglobin; Methemaglobin, Qualitative 04/01/2019 4.87 5.0983050 Hemoglobin; Methemaglobin, Quantitative 04/01/2019 6.15 7.5483051 Hemoglobin; Plasma 04/01/2019 6.09 7.5283060 Hemoglobin; Sulfhemoglobin, Qualitative 04/01/2019 6.89 8.5183065 Hemoglobin; Thermolabile 04/01/2019 6.75 7.0983068 Hemoglobin; Unstable Screen 04/01/2019 7.10 8.7183069 Hemoglobin; Urine 04/01/2019 3.66 4.0683070 Hemosiderin; Qualitative 04/01/2019 4.40 3.1683080 B-hexosaminidase, each assay 04/01/2019 14.06 17.3683088 Histamine 04/01/2019 24.61 30.3883090 Assay of homocystine 04/01/2019 14.06 17.3683150 Homovanillic Acid (Hva) 04/01/2019 16.81 19.9183491 Hydroxycorticosteriods,17-(17-Ohcs) 04/01/2019 14.60 18.0383497 Hydroxyindolacetic Acid 5-(Hiaa) 04/01/2019 10.75 13.2783498 Hydroxyprogesterone 17D 04/01/2019 22.64 27.9583499 Hydroxyprogesterone 20- 01/01/2018 D 32.9283500 Hydroxyproline; Free 04/01/2019 18.88 14.6283505 Hydroxyproline; Total 04/01/2019 20.26 14.10




HCPCS CODE



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83516 Immunoassay, non antibody 04/01/2019 10.68 11.8783518 Immunoassay,For Analyte Not Ab, Qual/Semi 04/01/2019 7.85 8.7283519 RIA nonantibody 04/01/2019 13.80 13.9083520 Immunoassay quant NOS nonab 04/01/2019 12.95 13.3283525 Insulin 04/01/2019 9.53 11.7683527 Assay Of Insulin 04/01/2019 10.79 13.3283528 Intrinsic Factor 04/01/2019 14.87 16.3683540 Iron 04/01/2019 5.99 6.6683550 Iron Binding Capacity 04/01/2019 7.28 8.9983570 Isocitric Dehydrog(Idh) 04/01/2019 7.37 9.1083582 Ketogenic Steriods, Fractionation 04/01/2019 11.81 14.5883586 Ketosteriods 17-(17-Ks); Total 04/01/2019 10.67 13.1783593 Ketosteriods17-(17-Ks);Fractionation 04/01/2019 21.92 27.0683597 Ketosteriods 17-(17-Ks)Urine 11Des/Oxy 04/01/1995 NC83605 Lactic (Lactic Acid) 04/01/2019 9.89 10.9983615 Lactic Dehydrogen Ase (Ld) (Ldh); 04/01/2019 5.03 6.2183625 Lactic Dehydrog Isoenzymes,Sep & Quant 04/01/2019 10.67 13.1683630 Lactoferrin, fecal (qual) 04/01/2019 16.36 15.3183631 Lactoferrin, fecal (quant) 04/01/2019 16.36 20.2083632 Lactogen Placental(Hpl)Chorion Somat 04/01/2019 16.85 20.8083633 Lactose, Urine; Qualitative 04/01/2019 8.44 5.6583655 Lead 04/01/2019 11.21 12.4683661 Lecithin-Spingomyelin Ratio Amnio Fluid 04/01/2019 18.32 22.6283662 L/S Ratio;Form Stability Test 04/01/2019 15.76 15.6083663 Fluoro polarize, fetal lung 04/01/2019 15.76 15.6083664 Lamellar bdy, fetal lung 04/01/2019 15.76 15.6083670 Leucine Aminopeptid Ase (Lap) 04/01/2019 7.64 9.4383690 Lipase 04/01/2019 5.74 7.0983695 Assay of lipoprotein(a) 04/01/2019 10.79 13.3283698 Assay lipoprotein pla2 04/01/2019 34.73 34.9283700 Lipopro bld, electrophoretic 04/01/2019 9.38 11.3983701 Lipoprotein bld, hr fraction 04/01/2019 25.40 33.6483704 Lipoprotein, bld, by nmr 04/01/2019 26.30 32.4683718 Lipoprotein, Dir; Hdl Cholesterol 04/01/2019 7.59 8.4383719 Lipoprotein Vldl Cholesterol 04/01/2019 9.70 11.9783721 Lipoprotein;Ldl Cholesterol 04/01/2019 8.84 9.8283722 Lipoprtn dir meas sd ldl chl 04/01/2019 26.30 BR83727 Luteinizing Releasing Factor (Lrh) 04/01/2019 14.33 17.6983735 Magnesium 04/01/2019 5.58 5.9483775 Malate Dehydrogenase 04/01/2019 6.14 7.5883785 Maganese 04/01/2019 20.50 25.3183789 Mass spectrometry, quantitative 04/01/2019 18.08 18.5883825 Mercury, Quantitative 04/01/2019 13.55 16.7383835 Metanephrines 04/01/2019 14.12 17.4383857 Methemalbumin 04/01/2019 8.95 11.0583861 Microfluid analysis tear osmolarity 04/01/2019 16.86 17.0083864 Mucopolysaccharides,Acid,Quantitative 04/01/2019 21.38 5.4583872 Mucin Synovial Fluid (Ropes Test) 04/01/2019 4.88 6.0383873 Myelin Basic Protein, Csf 04/01/2019 14.34 17.7083874 Myoglobin 04/01/2019 10.76 13.2983876 Myeloperoxidase (MPO) 04/01/2019 38.15 34.9283880 Natriuretic peptide 04/01/2019 31.43 34.9283883 Nephelometry, Ea Analyte,Nes 04/01/2019 11.33 13.9983885 Nickel 04/01/2019 20.42 25.2283915 Nucleotidase 5- 04/01/2019 9.29 11.4883916 Oligoclonal Immuno Globulin (Bands) 04/01/2019 20.54 20.6983918 Organic Acids Quantitative 04/01/2019 17.70 16.9383919 Organic Acids; qualitative, each specimen 04/01/2019 13.71 16.9383921 Organic acid, single, quant 04/01/2019 15.91 16.9383930 Osmolality; Blood 04/01/2019 6.12 6.8083935 Osmolality; Urne 04/01/2019 6.32 7.0183937 Assay For Osteocalcin 04/01/2019 24.87 30.7183945 Oxalate 04/01/2019 10.84 13.2583950 Oncoprotein, HER-2/neu 04/01/2019 53.68 66.2783951 Oncoprotein; DCP 04/01/2019 53.68 66.2783970 Parathormone (Parathyroid Hormone) 04/01/2019 34.40 42.4783986 Assay Ph body fluid NOS 04/01/2019 3.32 3.6883987 Exhaled breath condensate 04/01/2019 3.32 16.3483992 Phencyclidine (Pcp) 01/01/2018 15.13 19.7083993 Assay for fecal calprotectin 04/01/2019 16.36 20.2084030 Phenylalanine 04/01/2019 5.09 5.6684035 Phenylketones,Qualitative 04/01/2019 3.39 2.4184060 Phosphatase; Acid Total 04/01/2019 6.16 7.6084061 Phosphatase;Forensic Examination 01/01/2018 D 10.3384066 Phosphatase; Prostatic 04/01/2019 8.05 9.9484075 Phosphatase; Alkaline 04/01/2019 4.79 5.3384078 Phosphatase; Heat Stable 04/01/2019 6.20 7.5184080 Phosphatase; Isoenzymes 04/01/2019 12.32 15.2184081 Phosphatydylglycerol 04/01/2019 13.76 16.99




HCPCS CODE



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PREVIOUS MAXIMUM



84085 Phosphogluconate 6-Dehydrogenase Rbc 04/01/2019 7.87 6.3384087 Phosphohexose Isomerase 04/01/2019 8.60 10.6284100 Phosphorus Inorganic (Phosphate); 04/01/2019 4.39 4.8884105 Phosphate; Urine 04/01/2019 4.79 5.3384106 Porphobilinogen,Urine,Qualitative 04/01/2019 4.37 4.4184110 Porhoblinogen Urne Quantative 04/01/2019 7.04 8.6984112 Placental alpha microglobulin c/v qual 04/01/2019 73.58 66.2784119 Porphyrins Urine Qualitative 04/01/2019 10.02 7.8584120 Porphyrins,Quantitation & Fractionation 04/01/2019 12.26 15.1484126 Porphyrins Feces; Quantitative 04/01/2019 29.33 26.2184132 Potassium; Serum 04/01/2019 4.26 4.7384133 Potassium; Urine 04/01/2019 3.99 4.4384134 Prealbumin 04/01/2019 12.16 15.0184135 Pregnanediol 04/01/2019 15.95 15.7084138 Pregnanetriol 04/01/2019 15.79 19.4884140 Assay For Pregnenolone 04/01/2019 17.23 21.2784143 Assay/17-Hydroxypregnenolone 04/01/2019 19.01 23.4784144 Progesterone 04/01/2019 17.39 19.7184145 Procalcitonin (PCT) 04/01/2019 22.33 26.3784146 Prolactin 04/01/2019 16.15 19.9484150 Prostaglandin 04/01/2019 31.33 25.6784152 Assay of psa, complexed 04/01/2019 15.33 18.9284153 Prostate Specific Antigen(Psa) 04/01/2019 15.33 18.9284154 Prostate Specific Antigen (free) 04/01/2019 15.33 18.9284155 Protein; Total, Except Refractometry 04/01/2019 3.40 3.7784156 Assay Of Protein, Urine 04/01/2019 3.40 3.7784157 Assay Of Protein, Other 04/01/2019 3.40 3.7784160 Protein; Refractometric 04/01/2019 4.79 5.3384163 Pappa, serum 04/01/2019 12.55 15.4984165 Protein; electrophoretic fraction & quant, serum 04/01/2019 8.95 11.0584165 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6984166 Protein; electrophoretic fraction & quant, urine/CSF 04/01/2019 16.51 18.3584166 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6984181 Protein; western blot, fluid, w/intp & rept 04/01/2019 14.19 15.7384181 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6984182 Protein; western blot, fluid, w/intp & rept, immun probe 04/01/2019 21.91 18.5284182 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6984202 Protoporphyrin Rbc Quantitative 04/01/2019 11.96 14.7684203 Protoporphyrin Rbc Screen 04/01/2019 7.31 8.8684206 Proinsulin 04/01/2019 20.02 18.3284207 Pyridoxal Phosphate (Vitamin B-6) 04/01/2019 23.42 28.9184210 Pyruvate 04/01/2019 10.86 11.1784220 Pyruvate Kinase 04/01/2019 7.87 9.7184228 Quinine 04/01/2019 9.70 6.3384233 Receptor Assay;Estrogen 04/01/2019 65.91 66.2784234 Receptor Assay;Progesterone 04/01/2019 54.07 66.7584235 Receptor Assay;Endocrine (Nes Horm.) 04/01/2019 53.42 53.8484238 Receptor Assay;Non-Endocrine(Spec Recept 04/01/2019 30.47 37.6284244 Renin 04/01/2019 18.33 18.0984246 Renin; Furosemide Test 01/01/1995 NC84252 Riboflavin (Vitamin B-2) 04/01/2019 16.87 20.8284255 Selenium 04/01/2019 21.28 26.2784260 Serotonin 04/01/2019 25.82 31.8884270 Sex Hormone Binding Globulin (Shbg) 04/01/2019 18.11 19.7184275 Sialic Acid 04/01/2019 11.20 13.8284285 Silica 04/01/2019 19.61 24.2284295 Sodium; Serum 04/01/2019 4.46 4.9584300 Sodium; Urine 04/01/2019 4.50 5.0084302 Assay of sweat sodium 04/01/2019 4.50 5.0084305 Somtomedin 04/01/2019 17.72 21.8884307 Somatosation 04/01/2019 15.23 18.8084311 Spectrophotometry,Analyte Nes 04/01/2019 6.47 7.1984315 Specific Gravity,Excluding Urine 04/01/2019 2.46 2.5884375 Sugars, Tcl Or Paperchromatograpphy 04/01/2019 29.25 20.1884376 Sugars; single qualitative, each specimen 04/01/2019 5.09 5.6684377 Sugars; multiple qualitative, each specimen 04/01/2019 5.09 5.6684378 Sugars; single quantitative, each specimen 04/01/2019 9.61 7.6484379 Sugars; multiple quantitative, each specimen 04/01/2019 9.61 7.6484392 Sulfate, Urine 04/01/2019 4.40 4.8884402 Testosterone;Free 04/01/2019 21.23 26.2184403 Testosterone; Total 04/01/2019 21.51 20.9684410 Testosterone bioavailable 04/01/2019 42.74 54.4184425 Thiamine (Vitamin B-1) 04/01/2019 17.69 21.8484430 Thiocyanate 04/01/2019 9.70 7.8584431 Thromboxane, urine 04/01/2019 26.33 17.2984432 Thyroglobulin 04/01/2019 13.38 16.5284436 Thyroxine, Total 04/01/2019 6.36 7.0784437 Thyroxine; Requiring Elution 04/01/2019 5.99 6.6584439 Thyroxine, Free 04/01/2019 7.52 9.28




HCPCS CODE



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84442 Thyroxine Binding Globulin (Tbg) 04/01/2019 12.32 15.2184443 Thyroid Stimulating Hormone (Tsh) 04/01/2019 15.56 17.2984445 Thyroid Stimulating Immunoglobulins(Tsi) 04/01/2019 42.38 52.3284446 Tocopherol Alpha (Vitamin E) 04/01/2019 11.81 14.5984449 Assay For Transcortin 04/01/2019 15.00 18.5284450 Transaminase(Sgot);Aspartateamino (Ast) 04/01/2019 4.79 5.3384460 Transaminase(Sgpt);Alanineamino (Alt) 04/01/2019 4.91 5.4584466 Transferrin 04/01/2019 10.64 12.4884478 Triglycerides 04/01/2019 5.32 5.9184479 Tridothyronine(T-3),Resin Uptake 04/01/2019 5.99 6.6584480 Tridothyronine;Total (Tt3) 04/01/2019 11.81 14.5984481 Tridothyronine,Free, 04/01/2019 14.12 17.4384482 Tridithyronine;Reverse 04/01/2019 13.13 16.2284484 Troponin 04/01/2019 9.35 10.1384485 Trypsin Duodenal Fluid 04/01/2019 6.00 7.7384488 Trypsin,Feces,Qualitative 04/01/2019 6.08 7.5184490 Trypsin Feces Quantative 24 Hour 04/01/2019 7.45 7.8284510 Tyrosin 04/01/2019 8.67 10.7084512 Troponin, qualitative 04/01/2019 7.57 7.4584520 Urea Nitrogen, (Bun) Quantitative 04/01/2019 3.66 4.0784525 Urea Nitrogen,Semiquant (Reagent Strip) 04/01/2019 3.85 3.8884540 Urea Nitrogen,Urine 04/01/2019 4.40 4.8884545 Urea Nitrogen,Urine,Clearance 04/01/2019 6.12 6.8084550 Uric Acid, Blood, Chemical 04/01/2019 4.19 4.6584560 Uric Acid,Urine 04/01/2019 4.40 4.8884577 Urobilinogen Feces Quantitative 04/01/2019 14.00 1.8184578 Urobilinogen,Urine,Qualitative 04/01/2019 3.35 3.3484580 Urobilogen,Urine Quant, Time Specimen 04/01/2019 7.56 7.3084583 Urobilogen, Urine Semiquantitative 04/01/2019 4.66 2.9684585 Vanillymandelic Acid(Vma) Urine 04/01/2019 12.92 15.9584586 Vip Assay 04/01/2019 29.45 36.3584588 Vasopressin(Antidiuretic Hormone) Adh 04/01/2019 28.28 34.9284590 Vitamin A 04/01/2019 9.68 11.9484591 Assay of nos vitamin 04/01/2019 12.80 11.9484597 Vitamin K 04/01/2019 11.43 14.1284600 Volatiles (Acetic Anhydride Etc) 04/01/2019 13.40 16.5584620 Xylose Absorption Test,Blood And Or Urin 04/01/2019 9.87 10.0684630 Zinc 04/01/2019 9.49 11.7284681 C-Peptide 04/01/2019 17.35 21.4184702 Gonadotropin Chorionic;Quantitative 04/01/2019 12.55 15.4984703 Gonadotropin Chorionic;Qualitative 04/01/2019 6.97 7.7484704 HCG, free beta chain test 04/01/2019 12.55 15.4984830 Ovulation Tests,Vis Color Comp 04/01/2019 9.53 10.3284999 Unlisted Chemistry Procedure 01/01/2018 18.73 19.7285002 Bleeding Time 04/01/2019 4.18 4.6485004 Automated diff wbc count 04/01/2019 5.99 6.6585007 Blood Count; Manual Differential 04/01/2019 3.18 3.5385008 Bld Cnt; Manual Blood Smera Wo Diff Par 04/01/2019 3.18 1.6185009 Blood Count Differential Wbc Buffy Coat 04/01/2019 3.80 3.8385013 Spun Microhematocrit 04/01/2019 5.25 2.4485014 Hematocrit Other Than Spun 04/01/2019 2.20 2.4485018 Blood Count Hemoglobin 04/01/2019 2.20 2.4485025 Auto.Cbc,Plt,Auto Complt. Diff 04/01/2019 7.19 8.0085027 Automated Cbc W/ Platelet Count 04/01/2019 5.99 6.6585032 Manual cell count, each 04/01/2019 3.99 4.4385041 Red Blood Cell (Rbc) Only 04/01/2019 2.80 2.9685044 Reticulocyte Count, Manual 04/01/2019 3.99 4.4385045 Reticulocyte Count,Flow Cyometry 04/01/2019 3.70 4.1185046 Reticyte, HGB concentrate 04/01/2019 5.16 5.7385048 White Blood Cell (Wbc) 04/01/2019 2.35 2.6185049 Automated platelet count 04/01/2019 4.15 4.6185055 Reticulated Platelet Assay 04/01/2019 26.81 27.5585060 Bloodsmear, Interpretation By Physician 04/01/2019 18.51 7.6585097 Bone Marrow Smear; Interpretation Only 04/01/2019 66.35 37.38 26.86 17.2485130 Chromogen Subtrate Assay 04/01/2019 9.91 12.2385170 Clot Retraction 04/01/2019 12.23 1.6185175 Clot Lysis Time,Whole Blood Dilution 04/01/2019 15.28 4.6985210 Clotng Fctrs Plsma Ii Prthmbin Asay. 04/01/2019 10.82 4.6985220 Clotng Fctrs Plsma V Acg Or Pro Acclrn 04/01/2019 14.71 4.6985230 Clotng Fctrs-Factor Vii (Proconvertin) 04/01/2019 14.92 4.6985240 Clotng Fctr Viii(Ahg)One Stage 04/01/2019 14.92 4.6985244 Clotting Factor Viii Rel. Antigen Quan. 04/01/2019 17.02 4.6985245 Clot Fact Viii,Vw Fact,Ristocetin Cof 04/01/2019 19.12 23.6085246 Clot Fact Viii,Vw Fact Antigen 04/01/2019 19.12 23.6085247 Clot Fac Viii,Vw Fact,Multimet Anaysis 04/01/2019 19.12 23.6085250 Clotng Fctrs Plsma.Fctr Ix Ptc.Or Xmas 04/01/2019 15.87 4.6985260 Clotng Fctrs Plsma Fctr X Sturt.Prwer. 04/01/2019 14.92 4.6985270 Clotng Fctrs Plsma Fctr Xi Pta. 04/01/2019 14.92 4.6985280 Clotng Fctrs Plsma.Fctr Xii Hgeman 04/01/2019 16.13 4.69




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85290 Clotng Fctrs Plsma.Fctr Xiii.Fibrn.Stbzl 04/01/2019 13.61 9.4885291 Clotng Fctr Xiii Fibrin Stab Screen Solu 04/01/2019 7.41 9.1585292 Clotting; 04/01/2019 15.78 19.4885293 Clotting; 04/01/2019 15.78 19.4885300 Clotng.Inhbtrs.Or Anti Coglnts Ati Thrbn 04/01/2019 9.88 12.2085301 Clotting Inhibitors Or Anticoagulants; 04/01/2019 9.01 11.1285302 Clot Inhb/Anticoag;Protein C,Ag 04/01/2019 10.01 12.3685303 Clot Inhb/Anticoag;Protein C,Activity 04/01/2019 11.53 14.2485305 Clot Inhib/Anticoa,Protein S Tdt 04/01/2019 9.68 11.9485306 Clot Inhb/Anticoag;Protein S,Free 04/01/2019 12.77 14.1985307 Assay activated protein c 04/01/2019 12.77 14.1985335 Factor Inhibitor Test 04/01/2019 10.73 13.2585337 Thrombomodulin 04/01/2019 12.95 10.7285345 Coagulation Time Lee + White 04/01/2019 3.99 4.4385347 Coagulation Time Activated 04/01/2019 3.95 4.3885348 Coagulation Time Other Methods 04/01/2019 3.45 3.8385360 Euglobulin Lysis 04/01/2019 7.01 7.8585362 Fibrin Degrad Prod(Fdp)(Fsp)Agglut Slide 04/01/2019 5.74 7.0985366 Rin Degrad;Paracoagulation 04/01/2019 60.35 8.8785370 Fibrin Degrad;Quantitative 04/01/2019 9.47 11.6885378 Fibrin Degrad;D-Dimer;Semiqnt 04/01/2019 7.29 7.3485379 Fibrin Degrad,D-Dimer;Quant 04/01/2019 8.48 10.4785380 Fibrin degradation, vte 04/01/2019 8.48 10.4785384 Fibrinogen;Activity 04/01/2019 7.29 8.7485385 Fibrinogen;Antigen 04/01/2019 10.85 8.7485390 Fibrinolysins Screen; Intrp & Rep. 04/01/2019 11.61 5.3385390 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6985396 Fibrinolysis Clotting Assay, Whole Blood 04/01/2019 15.38 15.4485397 Coagulation/Fibrinolysis, Funct, NOS, Ea 04/01/2019 23.15 23.6085400 Fibrinolytic Fact/Inhib; Plasmin 04/01/2019 6.42 7.8585410 Fibrinolytic Mechanism Anti-Plasmin 04/01/2019 6.42 7.8585415 Plasminogen Activator 04/01/2019 14.33 9.4885420 Fibrinolytic Mechanism Plasminogen 04/01/2019 5.45 6.7285421 Fibrinolytic Mechanisms; 04/01/2019 8.49 7.8585441 Heinz Bodies;Direct 04/01/2019 3.89 3.1685445 Heinz Bodies Induced Acety Phenylhydraz 04/01/2019 5.68 7.0185460 Hemoglobin Fetal Differential Lysis 04/01/2019 6.44 7.9685461 Hemoglobin, fetal 04/01/2019 7.02 6.2385475 Hemolysin,Acid 04/01/2019 7.40 4.7885520 Heparin Assay 04/01/2019 10.91 13.4785525 Heparin Neutralization 04/01/2019 9.86 9.4485530 Heparin-Protamine Tolerance Test 04/01/2019 10.91 14.5985536 Iron stain peripheral blood 04/01/2019 5.39 4.7885540 Leucocyte Alkaline Phosphatase W Cnt 04/01/2019 7.17 8.8585547 Mechanical Fragility Rbc 04/01/2019 7.17 8.8585549 Muramidase 04/01/2019 15.62 19.2985555 Osmotic Fragility Rbc; Unincubated 04/01/2019 5.60 6.8885557 Osmotic Fragility Rbc;Incubated 04/01/2019 11.13 11.8885576 Platelet, aggregation (in vitro), ea agent 04/01/2019 19.89 10.2585576 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6985597 Platelet Neutralization 04/01/2019 14.98 18.5085598 Phospholipid neutralization hexagonal 04/01/2019 14.98 18.5085610 Prothrombin Time 04/01/2019 3.64 4.0485611 Prothrombin Time Sub,Plasma Frac,Ea 04/01/2019 3.65 4.0685612 Prothrombin Time Russell Viper Venom 04/01/2019 13.12 5.9485613 Russell Viper Venom Time Diluted 04/01/2019 7.98 5.9485635 Reptilase Test 04/01/2019 8.21 5.9485651 Sedimentation Rate Erythrocyte Nonauto 04/01/2019 3.29 3.6585652 Sedimentation Rate Erythrocyte, Auto. 04/01/2019 2.25 2.7885660 Sickling Of Red Blood Cells 04/01/2019 4.59 5.6785670 Thrombin Time Plasma 04/01/2019 4.81 4.7885675 Thrombin Time Titer 04/01/2019 5.71 7.0485705 Thromboplastin Inhib;Tissue 04/01/2019 8.03 9.9185730 Thrmplstn Time Partial Ptt Plasm Whl Bld 04/01/2019 5.00 6.1885732 Thrmplstn Time Partial Ptt Substit Plas 04/01/2019 5.39 6.6585810 Viscosity.Bld. 04/01/2019 9.73 12.0185999 Unlisted Hematology Procedure 01/01/2018 10.17 11.3086000 Agglutinins; Febrile, Ea Antigen 04/01/2019 5.82 7.1986001 Allergen specific igg 04/01/2019 5.87 5.3786003 Allergen Specific Ige 04/01/2019 4.35 5.3786005 Allergen Specific Ige 09/01/2005 NC 10.4586008 Allg spec ige recomb ea 04/01/2019 14.95 18.4586021 Antibody Identification Leukocyte Antibd 04/01/2019 12.55 15.4986022 Antibody Identification Platelet Antibod 04/01/2019 15.31 18.9086023 Antibody I.D. Platelet Assoc.Immunoglob. 04/01/2019 10.38 12.8286038 Antinuclear Antibodies (Ana) 04/01/2019 10.07 12.4486039 Antinuclear Antibodies (Ana);Titer 04/01/2019 9.30 11.4886060 Antistreptolysin O Titer 04/01/2019 6.08 7.5186063 Antistreptolysin O Screen 04/01/2019 4.81 5.93




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86077 Physician; Interp And Rpt Diff X-Match/A 04/01/2019 41.59 38.87 18.15 15.3386078 Physician; Interp And Rpt On Tr Invest 04/01/2019 41.59 38.87 22.53 11.8886079 Physician; Deviation From Std Proced 04/01/2019 41.34 38.62 22.39 12.1186140 C Reactive Protein 04/01/2019 4.31 5.3386141 High sensitivity C-reactive protein 04/01/2019 10.79 13.3286146 Glycoprotein antibody 04/01/2019 21.21 24.5286147 Cardiolipin (Phospholipid) Antibody 04/01/2019 21.21 24.5286148 Phospholipid antidbody 04/01/2019 13.39 16.5386152 Cell enumeration 01/01/2013 NC86153 26 Cell enumeration phys interp [reported w/ modifier 26] 04/01/2019 25.67 23.1186155 Chemotaxis Assay 04/01/2019 13.32 16.4586156 Cold Agglutinin; Screen 04/01/2019 6.05 5.9086157 Cold Agglutinin Titer 04/01/2019 6.72 8.3086160 Complement;Ag,Ea Component 04/01/2019 10.00 12.3586161 Complement;Func Activ,Ea Component 04/01/2019 10.00 12.3586162 Complement Total (Ch 50) Hemolytic 04/01/2019 16.94 20.9186171 Complement Fixation Tests, Ea Antigen 04/01/2019 8.34 10.3086185 Counterelectrophoresis Ea Antigen 01/01/2018 D 11.6886200 Ccp antibody 04/01/2019 10.79 13.3286215 Deoxyribonuclease Antibody 04/01/2019 11.04 13.6386225 Deoxyribonucleic Acid (Dna) Ab,Double 04/01/2019 11.45 14.1486226 Dna Antibody;Sing Stranded 04/01/2019 10.09 12.4686235 Extractable Nuclear Antigen (Ena)Antibod 04/01/2019 14.95 18.4586243 Fc Receptor 01/01/2018 D 22.9686255 Fluoresc noninfect agent antibody; screen, ea antibody 04/01/2019 10.04 12.4086255 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6986256 Fluoresc noninfect agent antibody; titer, ea antibody 04/01/2019 10.04 12.4086256 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6986277 Growth Hormone, Human (Hgh),Antibody 04/01/2019 13.12 16.1986280 Hemagglutination Inhibition Test (Hai) 04/01/2019 6.83 8.4386294 Immunoassay, tumor qual 04/01/2019 19.18 14.7086300 Immunoassay, tumor ca 15-3 04/01/2019 17.35 14.7186301 Immunoassay, tumor, ca 19-9 04/01/2019 17.35 14.7186304 Immunoassay, tumor ca 125 04/01/2019 17.35 14.7186305 Human epididymis protein 4 04/01/2019 17.35 14.7186308 Heterophile Antibodies;Screen 04/01/2019 4.79 5.3386309 Heterophile Antibodies;Titer 04/01/2019 5.39 6.6586310 Heterophile Antibodies,Absorp.Beef&G Pig 04/01/2019 6.14 7.5886316 Immunoassay For Tumor Antigen Each 04/01/2019 17.35 14.7186317 Immunoassay For Infectious Ag Or Ab;Nes 04/01/2019 12.49 15.4286318 Immunoassay For Infect Agent Ab Qual/Sem 04/01/2019 13.57 13.3286320 Immunoelectrophoresis; serum 04/01/2019 22.44 23.0686320 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6986325 Immunoelectrophoresis; other fluids 04/01/2019 18.64 23.0186325 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6986327 Immunoelectrophoresis; crossed (2-D assay) 04/01/2019 22.44 23.3486327 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 15.46 15.5286328 IA NFCT AB SARSCOV2 COVID19 04/10/2020 45.23 BR86329 Immunodiffusion Nes 04/01/2019 11.71 14.4586331 Immunodiffusion;Gel Dif Qual,Ea Ag Or Ab 04/01/2019 9.98 12.3286332 Immune Complex Assay 04/01/2019 20.31 25.0786334 Immunofixation electrophoresis; serum 04/01/2019 18.62 22.9986334 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6986335 Immunofixation electrophoresis; other fluids 04/01/2019 24.46 30.2086335 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6986336 Inhibin A 04/01/2019 12.99 14.7186337 Insulin Antibodies 04/01/2019 17.84 22.0386340 Intrinsic Factor Antibodies 04/01/2019 12.56 15.5186341 Islet Cell Antibody 04/01/2019 17.68 18.3886343 Leukocyte Histamine Release Test(Lhr) 04/01/2019 10.38 12.8286344 Leukocyte Phagocytosis 04/01/2019 7.79 8.2186352 Cell function assay w/stim 04/01/2019 113.22 139.7886353 Lymphocyte Transformation Mitogen 04/01/2019 40.85 50.4486355 B cells, total count 04/01/2019 31.44 38.8186356 Mononuclear cell antigen, quant., NOS 04/01/2019 22.31 27.5586357 Nk cells, total count 04/01/2019 31.44 38.8186359 T Cells Total Count 04/01/2019 31.44 38.8186360 T Cell Ratio 04/01/2019 39.15 48.3486361 T cells absolute count 04/01/2019 22.31 27.5586367 Stem cells, total count 04/01/2019 58.34 38.8186376 Microsomal Antibody (Thyroid); Each 04/01/2019 12.13 14.9786378 Migration Inhibitory Factor Test (Mif) 01/01/2018 D 17.3786382 Neutralization Test Viral 04/01/2019 14.09 17.4086384 Nitroblue Tetrazolium Dye Test (Ntd) 04/01/2019 10.21 11.7186386 Nuclear Matrix Protein 22 (NMP22), qualitative 04/01/2019 16.34 16.4386403 Particle Agglutination,Abor Ag,Each 04/01/2019 8.66 10.4986406 Particle agglutination test 04/01/2019 8.87 6.2386430 Rheumatoid Factor Qualitative 04/01/2019 4.73 5.8486431 Rheumatiod Factor;Quantitative 04/01/2019 4.73 5.84




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86480 Tb test, cell immun measure 04/01/2019 51.65 63.7786481 Tb antigen resp gamma interferon t-cell susp 04/01/2019 75.00 77.0986485 Skin Test;Candida 01/01/2018 9.00 10.0086486 Skin test, antigen, NOS 04/01/2019 3.49 3.4886490 Skin Test Coccidioidomycosis 04/01/2019 62.91 4.6586510 Skn Tst.Histoplasmosis 04/01/2019 4.48 4.2286580 Skin Test Tuberculosis Patch Intradermal 04/01/2019 5.72 4.6586590 Streptokinase Antibody 04/01/2019 9.50 11.3686592 Syphilis test non-Trep Qual 04/01/2019 3.56 4.4086593 Syphilis test non-Trep Quant 04/01/2019 3.67 4.5386602 Antibody;Actinomyces 04/01/2019 8.48 10.4786603 Antibody;Adenovirus 04/01/2019 10.73 13.2486606 Antibody;Aspirgillus 04/01/2019 12.55 14.1586609 Antibody;Bacterium,Nes 04/01/2019 10.73 13.2586611 Bartonella antibody 04/01/2019 8.48 10.4786612 Antibody;Blastomyces 04/01/2019 10.76 13.2886615 Antibody;Bordetella 04/01/2019 10.99 13.5786617 Lyme disease antibody 04/01/2019 12.91 15.9486618 Ab;Borellia Burgdorferi(Lyme Diease) 04/01/2019 15.77 17.5286619 Antibody;Borrelia (Relapsing Fever) 04/01/2019 11.15 13.7686622 Antibody;Brucella 04/01/2019 7.44 9.1986625 Antibody;Campylobacter 04/01/2019 10.94 13.5086628 Antibody;Candida 04/01/2019 10.01 12.3586631 Antibody;Chlamydia 04/01/2019 9.86 12.1786632 Antibody;Chlamydia,Igm 04/01/2019 10.57 13.0586635 Antibody;Coccidoides 04/01/2019 9.56 11.8186638 Antibody;Coxiella Brunetii (Q Fever) 04/01/2019 10.10 12.4786641 Antibody;Cryptococcus 04/01/2019 12.01 14.1586644 Antibody;Cytomegalovirus (Cmv) 04/01/2019 11.99 14.8186645 Antibody;Cytomegalovirus (Cmv),Igm 04/01/2019 14.04 17.3386648 Antibody;Diphtheria 04/01/2019 12.68 14.1586651 Antibody;Encephalitis,Calf, (La Crosse) 04/01/2019 10.99 13.5786652 Antibody;Encephalitis,Eastern Equine 04/01/2019 10.99 13.5786653 Antibody;Encephalitis,St. Louis 04/01/2019 10.99 13.5786654 Antibody;Encephalitis,Western Equine 04/01/2019 10.99 13.5786658 Ab;Enterovirus(E.G., Coxsakie,Echo,Poli) 04/01/2019 10.85 13.4086663 Antibody;Epstein-Barr (Eb)Virus,Early Ag 04/01/2019 10.94 13.5086664 Ab;Epstein-Barr Virus Nuclear Ag(Ebna 04/01/2019 12.74 14.1586665 Epstein Barr Virus,Viral Capsid 04/01/2019 15.12 14.1586666 Ehrlichia antibody 04/01/2019 8.48 10.4786668 Antibody;Francisella Tularensis 04/01/2019 10.62 10.7086671 Antibody;Fungus,Nes 04/01/2019 10.22 12.6186674 Antibody;Giardia Lamblia 04/01/2019 12.26 15.1486677 Antibody;Helicobacter Pylori 04/01/2019 12.64 14.9386682 Antibody;Helminth,Nes 04/01/2019 10.84 13.3886684 Antibody;Hemophilus Influenza 04/01/2019 13.20 16.3086687 Htlv-1 04/01/2019 6.99 8.6386688 Antibody;Htlv-Ii 04/01/2019 11.67 14.4186689 Htlv Or Hiv Antibody;Confirmatory 04/01/2019 16.13 19.9186692 Antibody;Hepatitis,Delta Agent 04/01/2019 14.30 17.6686694 Ab;Herpes Simplex,Non-Specific Type Te 04/01/2019 11.99 14.8186695 Antibody;Herpes Simplex,Type 1 04/01/2019 10.99 13.5786696 Herpes simplex type 2 04/01/2019 16.13 19.9186698 Antibody;Histoplasma 04/01/2019 10.41 12.8686701 Antibody;Hiv-1 04/01/2019 8.23 9.1486702 Antibody;Hiv-2 04/01/2019 11.27 13.9186703 Antibody;Hiv-1And Hiv-2,Single Result 04/01/2019 11.42 14.1086704 Hepatitis B core antibody 04/01/2019 10.04 12.4086705 Hepatitis B core antibody 04/01/2019 9,81 12.1186706 Hepatitis B core surface antibody 04/01/2019 8.95 11.0586707 Hepatitis Be antibody 04/01/2019 9.64 11.9086708 Hepatitis A antibody 04/01/2019 10.32 12.7486709 Hepatitis A antibody 04/01/2019 9.38 11.5886710 Antibody;Influenza Virus 04/01/2019 11.30 13.9486711 JC Antibody 04/01/2019 12.67 14.8186713 Antibody;Legionella 04/01/2019 12.75 15.7486717 Antibody;Leishmania 04/01/2019 10.21 12.6086720 Antibody;Leptospira 04/01/2019 12.15 13.5786723 Antibody;Listeria Monocytogenes 04/01/2019 10.99 13.5786727 Antibody;Lymphocytic Choriomeningitis 04/01/2019 10.73 13.2486729 Antibody;Lymphogranuloma Venereum 01/01/2018 D 15.6186732 Antibody;Mucormycosis 04/01/2019 11.25 13.5786735 Antibody;Mumps 04/01/2019 10.88 13.4386738 Antibody;Mycoplasma 04/01/2019 11.03 13.6286741 Antibody;Neisseria Meningititis 04/01/2019 10.99 13.5786744 Antibody;Nocardia 04/01/2019 11.99 13.5786747 Antibody;Parovirus 04/01/2019 12.53 15.4786750 Antibody;Plasmodium(Malaria) 04/01/2019 10.99 13.5786753 Antibody;Protozoa,Nes 04/01/2019 10.32 12.74




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86756 Antibody;Respiratory Syncytial Virus 04/01/2019 11.93 13.2686757 Rickettsia antibody 04/01/2019 16.13 19.9186759 Antibody;Rotavirus 04/01/2019 13.67 13.5786762 Antibody;Rubella 04/01/2019 11.99 14.8186765 Antibody;Rubeola 04/01/2019 10.73 13.2586768 Antibody;Salmonella 04/01/2019 10.99 13.5786769 SARS-COV-2 COVID-19 ANTIBODY 04/10/2020 42.1386771 Antibody;Shigella 04/01/2019 18.36 13.5786774 Antibody;Tetanus 04/01/2019 12.33 15.2386777 Antibody;Toxoplasma 04/01/2019 11.99 14.8186778 Antibody;Toxoplasma,Igm 04/01/2019 12.01 14.8286780 Treponema pallidum 04/01/2019 12.26 13.6286784 Antibody;Trichinella 04/01/2019 10.47 12.9286787 Antibody;Varicella-Zoster 04/01/2019 10.73 13.2586788 West nile virus ab, igm 04/01/2019 14.04 17.3386789 West nile virus antibody 04/01/2019 11.99 14.8186790 Antibody;Virus,Nes 04/01/2019 10.73 13.2586793 Antibody;Yersinia 04/01/2019 10.99 13.5786794 Zika virus igm antibody 04/01/2019 14.04 17.3386800 Thyroglobulin Antibody 04/01/2019 13.25 16.3786803 Hepatitis C antibody 04/01/2019 13.21 13.5686804 Hepatitis C antibody 04/01/2019 12.91 15.9486805 Lyphocytotox Assy,Vis Crosmtch,W/ Titra 04/01/2019 142.13 53.8086806 Lymphocytox Assy,Vis Crsmtch,W/O Titra 04/01/2019 39.66 48.9686807 Serum Screening Cytoxic Pra, Std Method 04/01/2019 58.99 40.7286808 Serum Screening Cytoxic Pra, Quikmethod 04/01/2019 24.74 30.5386812 Hla Typing A B Or C, Single Antigen 04/01/2019 21.50 26.5586813 Hla Typing A B Or C,Multi. Antigens 04/01/2019 48.33 59.6786816 Hla Typing, Dr/Dq Single Antigen 04/01/2019 23.21 28.6686817 Hla Typing. Dr/Dq Multiple Antigens 04/01/2019 79.61 66.2486821 Lymphocyte Culture, Mixed (Mlc) 04/01/2019 30.47 33.2186822 Lymphocyte Culture, Primed (Plc) 01/01/2018 D 42.1586825 Hla x-match, non-cytotoxic 04/01/2019 82.12 82.6386826 Hla x-match, non-cyt add-on 04/01/2019 27.40 27.5586828 Hla class 1 &2 anti qual 04/01/2019 48.14 40.7286829 Hla class 1/2 anti qual 04/01/2019 48.14 30.5386830 Hla class 1 pheno 04/01/2019 71.64 83.0686831 Hla class 2 pheno 04/01/2019 61.41 71.2086832 Hla class 1 high def qual 04/01/2019 242.81 130.5386833 Hla class 2 high def qual 04/01/2019 244.35 118.6786834 Hla class 1 semi qual panel 04/01/2019 297.97 367.8686835 Hla class 2 semi qual panel 04/01/2019 269.14 332.2686849 Unlisted Immunology Precedure 01/01/2018 102.61 114.0186850 Antibody Screen,Rbc,Ea Serum Technique 04/01/2019 7.33 3.9486860 Antibody Elution (Rbc),Ea Elution 01/01/2018 26.96 29.9686870 Antibody Id,Rbc Ab,Ea Panel,Ea Technique 01/01/2018 22.58 25.0986880 Agh Tst;Direct,Ea Antiserum(Direct Coomb 04/01/2019 4.49 5.5486885 Coombs Test 04/01/2019 4.77 5.8986886 Agh Test;Indirect,Titer,Ea Antiserum 04/01/2019 4.31 5.3386890 Autologous Bld Or Comp,Collect,Proc,Sto 01/01/2018 12.14 13.4986891 Auto Donor Blood;Intra/Postop Salvage 01/01/2018 999.59 1,110.6686900 Blood Typing;Abo 04/01/2019 2.49 3.0886901 Blood Typing;Rh(D) 04/01/2019 2.49 3.0886902 Blood type antigen donor reagent serum ea 04/01/2019 4.76 3.9486904 Ag Screen For Bld Using Pat Serum,Pre Un 04/01/2019 12.26 9.7986905 Rbc Antigens,Other Than Abo Or Rh,Ea 04/01/2019 3.19 3.9486906 Rh Phenotyping,Complete 04/01/2019 6.46 7.9786910 Typing For Paternity Test,Ea Ag System 01/01/1994 NC86911 Paternity Test, Ea Add Ag System 01/01/1994 NC86920 Compatibil Test Ea Unit;Immediate Spin 01/01/2018 21.45 23.8386921 Compatibil Test Ea Unit;Incubation Tech 01/01/2018 21.45 23.8386922 Compatibility Test Ea Unit;Ahg Technique 01/01/2018 21.45 23.8386923 Compatibility test, electric 01/01/2018 13.46 14.9586927 Fresh Frozen Plasma,Thawing Ea Unit 01/01/2018 8.78 9.7686930 Frozen Blood,Prep For Freezing Ea Unit 01/01/2018 21.45 23.8386931 Frozen Blood;Thawing Ea Unit 01/01/2018 32.36 35.9686932 Frozen Bld; With Freezing&Thawing,Ea Unit 01/01/2018 42.89 47.6586940 Hemolysins Agglutinins, Auto,Screen,Each 04/01/2019 6.83 8.4486941 Hemolysins Agglut,Auto,Screen,Ea;Incubat 04/01/2019 10.09 12.4686945 Irradiation Of Blood Product,Ea Unit 01/01/2018 10.54 11.7186950 Leukocyte Transfusion 01/01/2018 28.58 31.7686960 Vol reduction of blood/prod 01/01/2018 13.46 14.9586965 Pooling Of Platelets Or Other Blood Prod 01/01/2018 13.50 15.0086970 Pretreat Rbc W Chem Agents Or Drugs,Ea 01/01/2018 14.43 16.0386971 Pretreat Rbc & Incubation W Enzymes 01/01/2018 14.43 16.0386972 Pretreat Rbc By Density Gradient Separat 01/01/2018 17.56 19.5186975 Pretreat Serum For Ab Id;Ancu Drugs 01/01/2018 14.43 16.0386976 Pretreat Serum For Ab Id;By Dilition 01/01/2018 14.43 16.0386977 Pretreat Serum Ab Id;Incub W Inhib 01/01/2018 14.43 16.03




HCPCS CODE



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86978 Pretreat Serum By Autoabsorption 01/01/2018 17.56 19.5186985 Splitting Of Bld Or Bld Products,Ea Unit 01/01/2018 13.50 15.0086999 Unlisted Transfusion Medicine Service 01/01/2018 13.46 14.9587003 Animal Inoculation Small Observ Dissect 04/01/2019 14.03 17.3287015 Concentration For Parasites Ova Tb Bacil 04/01/2019 5.57 5.9487040 Culture, Bacterial, Definitive; Blood 04/01/2019 8.60 10.6287045 Culture Bact Definitive Aerobic Stool0 04/01/2019 7.87 9.7187046 Stool cultr, bacteria, each 04/01/2019 7.87 9.7187070 Culture Bact Defin Aerobic Other Source 04/01/2019 7.18 8.8787071 Culture bacteri aerobic othr 04/01/2019 7.87 9.7187073 Culture bacteria anaerobic 04/01/2019 7.87 9.7187075 Culture Bacterial Any Source Anaerobic 04/01/2019 7.89 9.7487076 Culture,Bac,An;Id,Ea Anaerobic Organism 04/01/2019 6.73 8.3187077 Culture aerobic identify 04/01/2019 6.73 8.3187081 Culture Bacterial Screening Single Organ 04/01/2019 5.52 6.8287084 Culture Presumptive,Kit W Colony Estim. 04/01/2019 20.30 8.8787086 Culture Bact Urine Quantit Colony Count 04/01/2019 6.73 8.3087088 Culture Bact Urine Identification 04/01/2019 6.74 8.3387101 Culture Fungi Isolation Skin 04/01/2019 6.42 7.9387102 Culture,Fungi,Isolation;Other Source 04/01/2019 7.01 8.6587103 Culture,Fungi,Isolation;Blood 04/01/2019 15.35 9.2887106 Culture,Fungi,Def.Id Ea Fungus 04/01/2019 8.60 10.6287107 Fungi identification, mold 04/01/2019 8.60 10.6287109 Culture Mycoplasma Any Source 04/01/2019 12.83 15.8387110 Culture,Chlamydia 04/01/2019 16.33 20.1687116 Culture Tubercle/Acid Fast Bacil Isolatn 04/01/2019 9.00 11.1287118 Culture Tub/Acid Fast Bacil Defin Identf 04/01/2019 10.96 11.2687140 Culture Typing Fluorescent Method 04/01/2019 4.64 5.7387143 Culture Typing Gas Liquid Chromatog Glc 04/01/2019 10.44 12.8887147 Culture Typing Serologic Agglut Grouping 04/01/2019 4.31 4.6987149 DNA/RNA direct probe 04/01/2019 16.71 20.6387150 DNA/RNA, amplified probe 04/01/2019 29.24 36.1187152 Culture type pulse field gel 04/01/2019 5.81 5.3887153 DNA/RNA sequencing 04/01/2019 96.13 118.6887158 Culture Typing Other Methods 04/01/2019 5.81 5.3887164 Darkfield Exam Any Source W Spec Collect 04/01/2019 8.95 11.0587164 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6987166 Darkfield Exam Any Source Wo Spec Collct 04/01/2019 9.42 11.6387168 Macroscopic exam arthropod 04/01/2019 3.56 4.4087169 Macacroscopic exam parasite 04/01/2019 3.56 4.4087172 Pinworm exam 04/01/2019 3.56 4.4087176 Endotoxin Bacterial Homogen Tissue Cult 04/01/2019 4.91 6.0587177 Ova Parasites Direct Smears Conc Identif 04/01/2019 7.42 9.1687181 Sensitiv Studies Antibiot Agar Diffusion 04/01/2019 3.95 1.8287184 Sensitiv Studies Antibiot Disc Method 04/01/2019 5.75 7.1087185 Microbe susceptible, enzyme 04/01/2019 3.95 1.8287186 Sensitiv Studies Microtiter(Mic)<8 Antib 04/01/2019 7.21 7.9587187 Sensitivity Studies;Antbiotic;Mbc 04/01/2019 30.13 9.2787188 Sensitiv Studies Tube Dilution Ea Antibi 04/01/2019 5.54 6.8387190 Sensitivity Study Tuber.Bacill.One Drug 04/01/2019 5.48 5.8187197 Serum Bactericidal Titer 04/01/2019 12.52 15.4687205 Smear W Interpret Primary Source Routine 04/01/2019 3.56 4.4087206 Smear W Interp Fluorescent/Acid Fast Stn 04/01/2019 4.49 5.5487207 Smear, prim source w/ interp; special stain 04/01/2019 5.00 5.9487207 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6987209 Smear, complex stain 04/01/2019 14.98 17.8187210 Smear W Interp Wet Mount Simple Stain 04/01/2019 4.37 4.4087220 Tissue Exam For Fungi (Leg,Koh Slide) 04/01/2019 3.56 4.4087230 Toxin Or Antitoxin,Tissue Culture 04/01/2019 16.45 20.3187250 Virus Inoc Embryo Eggs/Tiss Cult W Obsrv 04/01/2019 16.30 20.1287252 Virus Id;Tissue Cult Inoculation & Obser 04/01/2019 21.73 26.8287253 Virus Id;Tissue Culture,Add Studies 04/01/2019 16.84 20.7887254 Virus inoculation, shell via 04/01/2019 16.30 20.1287255 Genet virus isolate, hsv 04/01/2019 28.22 34.8487260 Adenovirus antigen detection by DFA 04/01/2019 10.82 12.3387265 Pertussis antigen detection by DFA 04/01/2019 9.99 12.3387267 Enterovirus antibody, dfa 04/01/2019 10.07 12.3387269 Giardia Ag, If 04/01/2019 10.21 12.3387270 Chlamydia trachomatis antigen detection by DFA 04/01/2019 9.99 12.3387271 Cryptosporidum/gardia ag, if 04/01/2019 10.07 12.3387272 Cryptosporidum antigen detection by DFA 04/01/2019 9.99 12.3387273 Herpes simplex 2, ag, if 04/01/2019 9.99 12.3387274 Herpes simplex antigen detection by DFA 04/01/2019 9.99 12.3387275 Influenza b, ag 04/01/2019 9.99 12.3387276 Influenza A antigen detection by DFA 04/01/2019 12.05 12.3387277 Legionella micdadei, ag, if 01/01/2018 D 15.6787278 Legionella pneumophila antigen detection by DFA 04/01/2019 11.70 12.3387279 Parainfluenza, ag, if 04/01/2019 12.32 12.3387280 Respiratory synctial antigen detection by DFA 04/01/2019 10.07 12.33




HCPCS CODE



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CURRENT MAXIMUM




PREVIOUS MAXIMUM



87281 Pneumocystis carinii, ag, if 04/01/2019 9.99 12.3387283 Rubeola, ag, if 04/01/2019 45.60 12.3387285 Treponema pallidum antigen detection by DFA 04/01/2019 9.99 12.3387290 Varicella antigen detection by DFA 04/01/2019 10.07 12.3387299 Infectious agent antigen detection, NOS, by DFA 04/01/2019 12.08 12.3387300 Ag detection, polyval, if 04/01/2019 9.99 12.3387301 Adenovirus antigen detection by EIA 04/01/2019 9.99 12.3387305 Aspergillus ag, eia 04/01/2019 9.99 12.3387320 Chlamydia trachomatis antigen detection by EIA 04/01/2019 11.25 12.3387324 Clostridium difficile toxin A antigen detectn by EIA 04/01/2019 9.99 12.3387327 Cryptococcus neoform ag, eia 04/01/2019 10.07 12.3387328 Cryptosporidum antigen detection by EIA 04/01/2019 10.37 12.3387329 Giardia Ag, Eia 04/01/2019 9.99 12.3387332 Cytomegalovirus antigen detection by EIA 04/01/2019 9.99 12.3387335 E. coli 0157 antigen detection by EIA 04/01/2019 9.99 12.3387336 Entamoeb hist dispr, ag, eia 04/01/2019 12.00 12.3387337 Entamoeb hist group, ag, eia 04/01/2019 9.99 12.3387338 Helicobacter pylori, stool 04/01/2019 13.32 14.8087339 Hpylori ag, eia 04/01/2019 12.00 12.3387340 Hepatitis B surface antigen detection by EIA 04/01/2019 8.61 9.5887341 Hepatitis b surface, ag, eia 04/01/2019 8.61 9.5887350 Hepatitis Be antigen detection by EIA code 04/01/2019 9.61 11.8687380 Hepatitis, delta agent antigen detection by EIA 04/01/2019 13.77 16.8887385 Histoplasma capsulatum antigen detection by EIA 04/01/2019 9.99 12.3387389 HIV-1 Ag, HIV-1 Ab, or HIV-2 Ab by EIA 04/01/2019 22.30 24.7787390 HIV-1 antigen detection by EIA 04/01/2019 18.05 11.4987391 HIV-2 antigen detection by EIA 04/01/2019 16.43 11.4987400 Influenza a/b, ag, eia 04/01/2019 10.60 12.3387420 Respiratory synctial antigen detection by EIA 04/01/2019 10.43 12.3387425 Rotavirus antigen detection by EIA 04/01/2019 9.99 12.3387426 Coronavirus ag ia 06/25/2020 BR87427 Shiga-like toxin ag, eia 04/01/2019 9.99 12.3387430 Streptococcus A antigen detection by EIA 04/01/2019 12.61 12.3387449 Infectious agent antigen detection by EIA, NOS 04/01/2019 11.10 12.3387450 Infectious agent antigen detection by EIA, NOS 04/01/2019 8.00 9.8787451 Ag detect polyval, eia, mult 04/01/2019 8.00 9.8787470 Bartonella detection by DNA, direct probe 01/01/2018 D 26.1987471 Bartonella detection by DNA, amplified probe 04/01/2019 29.24 36.1187472 Bartonella detection by DNA, quantification 04/01/2019 35.70 44.0787475 Lyme disease detection by DNA, direct probe 04/01/2019 16.71 20.6387476 Lyme disease detection by DNA, amplified probe 04/01/2019 29.24 36.1187477 Lyme disease detection by DNA, quantification 01/01/2018 D 55.9487480 Candida detection by DNA, direct probe 04/01/2019 16.71 20.6387481 Candida detection by DNA, amplified probe 04/01/2019 29.24 36.1187482 Candida detection by DNA, quantification 04/01/2019 41.81 42.9687483 Cns dna amp probe type 12-25 04/01/2019 347.32 579.4587485 Chlamydia pneumoniae detect by DNA, dir probe 04/01/2019 16.71 20.6387486 Chlamydia pneumoniae detect by DNA, amp probe 04/01/2019 29.24 36.1187487 Chlamydia pneumoniae detect by DNA, quantif 04/01/2019 35.70 44.0787490 Chlamydia trachomatis detect by DNA, dir probe 04/01/2019 17.06 20.6387491 Chlamydia trachomatis detect by DNA, amp probe 04/01/2019 29.24 36.1187492 Chlamydia trachomatis detect by DNA, quantif 04/01/2019 40.10 14.9087493 C diff amplified probe 04/01/2019 29.24 36.1187495 Cytomegalovirus detection by DNA, direct probe 04/01/2019 22.52 20.6387496 Cytomegalovirus detection by DNA, amp probe 04/01/2019 29.24 36.1187497 Cytomegalovirus detection by DNA, quantif 04/01/2019 35.70 44.0787498 Enterovirus, dna, amp probe 04/01/2019 29.24 36.1187500 Vancomycin, DNA, amplified probe 04/01/2019 29.24 36.1187501 Infectious agent dna/rna influenza ea type 04/01/2019 42.77 52.7987502 Infectious agent dna/rna influenza 1st 2 types 04/01/2019 78.80 87.5587503 Nfct agent dna/rna influenza 1+ types ea addl 04/01/2019 21.92 21.3787505 Nfct agent detection gi 04/01/2019 106.91 132.6887506 Iadna-dna/rna probe tq 6-11 04/01/2019 197.62 219.5887507 Iadna-dna/rna probe tq 12-25 04/01/2019 347.32 431.0587510 Gardnerella vaginalis detect by DNA, direct probe 04/01/2019 16.71 20.6387511 Gardnerella vaginalis detect by DNA, amp probe 04/01/2019 29.24 36.1187512 Gardnerella vaginalis detection by DNA, quantif. 04/01/2019 34.80 42.9687515 Hepatitis B detection by DNA, direct probe 01/01/2018 D 26.1987516 Hepatitis B detection by DNA, amplified probe 04/01/2019 29.24 36.1187517 Hepatitis B detection by DNA, quantification 04/01/2019 35.70 44.0787520 Hepatitis C detection by RNA, direct probe 04/01/2019 23.42 20.6387521 Hepatitis C detection by RNA, amplified probe 04/01/2019 29.24 36.1187522 Hepatitis C detection by RNA, quantification 04/01/2019 35.70 44.0787525 Hepatitis G detection by DNA, direct probe 04/01/2019 22.35 20.6387526 Hepatitis G detection by DNA, amplified probe 04/01/2019 29.45 36.1087527 Hepatitis G detection by DNA, quantification 04/01/2019 34.80 42.9687528 Herpes simplex detection by DNA, direct probe 04/01/2019 16.71 20.6387529 Herpes simplex detection by DNA, amp probe 04/01/2019 29.24 36.1187530 Herpes simplex detection by DNA, quantification 04/01/2019 35.70 44.07




HCPCS CODE



TC -- Tech. comp.



CURRENT MAXIMUM




PREVIOUS MAXIMUM



87531 Herpes virus-6 detection by DNA, direct probe 04/01/2019 43.50 20.6387532 Herpes virus-6 detection by DNA, amp probe 04/01/2019 29.24 36.1187533 Herpes virus-6 detection by DNA, quantification 04/01/2019 34.80 42.9687534 HIV-1 detection by DNA, direct probe 04/01/2019 16.71 20.6387535 HIV-1 detection by DNA, amplified probe 04/01/2019 29.24 36.1187536 HIV-1 detection by DNA, quantification 04/01/2019 70.91 87.5587537 HIV-2 detection by DNA, direct probe 04/01/2019 16.71 20.6387538 HIV-2 detection by DNA, amplified probe 04/01/2019 29.24 36.1187539 HIV-2 detection by DNA, quantification 04/01/2019 43.97 44.0787540 Legionella pneumophila detect by DNA, dir probe 04/01/2019 16.71 20.6387541 Legionella pneumophila detect by DNA, amp probe 04/01/2019 29.24 36.1187542 Legionella pneumophila detect by DNA, quantif 04/01/2019 34.80 42.9687550 Mycobacteria detection by DNA, direct probe 04/01/2019 16.71 20.6387551 Mycobacteria detection by DNA, amplified probe 04/01/2019 36.18 36.1187552 Mycobacteria detection by DNA, quantification 04/01/2019 35.70 44.0787555 M. tuberculosis detection by DNA, direct probe 04/01/2019 20.16 20.6387556 M. tuberculosis detection by DNA, amp probe 04/01/2019 31.26 36.1187557 M. tuberculosis detection by DNA, quantification 04/01/2019 35.70 44.0787560 M. avium-intracellulare by DNA, direct probe 04/01/2019 20.47 20.6387561 M. avium-intracellulare by DNA, amplified probe 04/01/2019 29.24 36.1187562 M. avium-intracellulare by DNA, quantification 04/01/2019 35.70 44.0787580 M. pneumoniae by DNA, direct probe 04/01/2019 16.71 20.6387581 M. pneumoniae by DNA, amplified probe 04/01/2019 29.24 36.1187582 M. pneumoniae by DNA, quantification 04/01/2019 226.97 42.9687590 N. gonorrhoeae by DNA, direct probe 04/01/2019 20.16 20.6387591 N. gonorrhoeae by DNA, amplified probe 04/01/2019 29.24 36.1187592 N. gonorrhoeae by DNA, quantification 04/01/2019 35.70 14.9087623 HPV low-risk types 04/01/2019 29.24 36.3087624 HPV high-risk types 04/01/2019 29.24 36.3087625 HPV types 16 & 18 only 04/01/2019 30.41 36.3087631 Resp virus 3-5 targets 04/01/2019 118.79 131.9987632 Resp virus 6-11 targets 04/01/2019 177.86 219.5887633 Resp virus 12-25 targets 04/01/2019 347.32 428.7987634 Rsv dna/rna amp probe 04/01/2019 65.00 72.2287635 SARS COVID - 19 amp prb 03/01/2020 35.9287640 Staph a, dna, amp probe 04/01/2019 29.24 36.1187641 Mr-staph, dna, amp probe 04/01/2019 29.24 36.1187650 Strep A by DNA, direct probe 04/01/2019 16.71 20.6387651 Strep A by DNA, amplified probe 04/01/2019 29.24 36.1187652 Strep A by DNA, quantification 04/01/2019 34.80 42.9687653 Strep b, dna, amp probe 04/01/2019 29.24 36.1187660 Trichomonas vagin, dir probe 04/01/2019 16.71 20.6387661 Trichomonas vaginalis amplif 04/01/2019 29.24 36.1187662 Zika virus dna/rna amp probe 04/01/2019 42.77 52.7987797 Infect agt detect by nucleic acid, NOS, dir probe 04/01/2019 22.52 20.6387798 Infect agt detect by nucleic acid, NOS, amp probe 04/01/2019 29.24 36.1187799 Infect agt detect by nucleic acid, NOS, quantif. 04/01/2019 35.70 44.0787800 Detect agnt mult, dna, direc 04/01/2019 33.43 41.2787801 Detect agnt mult, dna, ampli 04/01/2019 58.49 72.2287802 Strep B detection immunoassay 04/01/2019 9.99 12.3387803 Clostr difficile toxin A immuno detec 04/01/2019 12.00 12.3387804 Influenza immunoassay detect w optic 04/01/2019 12.41 12.3387806 HIV antigen w/HIV antibodies 04/01/2019 24.58 24.7787807 Rsv assay w/optic 04/01/2019 11.10 12.3387808 Trichomonas assay w/optic 04/01/2019 11.47 12.3387809 Adenovirus assay w/ optic 04/01/2019 16.32 12.3387810 Chlamydia trachomatis detect by immunoassay 04/01/2019 26.47 12.3387850 N. gonorrhoeae detection by immunoassay 04/01/2019 18.42 12.3387880 Strep A detection by immunoassay 04/01/2019 12.40 12.3387899 Infect agent detect by immunoassay, NOS 04/01/2019 12.05 12.3387900 Phenotype, infect agent drug 04/01/2019 108.62 134.1087901 Genotype, dna, hiv reverse t 04/01/2019 214.54 264.8687902 Hepatitis C genotype analysis 04/01/2019 214.54 264.8687903 Phenotype, dna hiv w/culture 04/01/2019 407.31 502.7387904 Phenotype, dna hiv w/clt add 04/01/2019 21.73 26.8287905 Infect Agent Enzym Activity O.T. Virus 04/01/2019 11.31 12.5787906 Nfct gexyp dna/rna hiv 1 other region 04/01/2019 107.27 132.4487910 Genotype, infect agent nucleic acid 04/01/2019 214.54 264.8687912 Heb B virus 04/01/2019 214.54 264.8687999 Unlisted Microbiology Procedure 01/01/2018 38.16 42.4088000 Necropsy(Autopsy)Gross Exam Only Wo Cns 01/01/1994 NC88005 Necropsy(Autopsy)Gross Exam Only W Brain 01/01/1994 NC88007 Necropsy(Autopsy)Gross Exam W Brain Sp Cord 01/01/1994 NC88012 Necropsy(Autopsy)Gross Infant W Brain 01/01/1994 NC88014 Necropsy(Autopsy)Still/Newborn W Brain 01/01/1994 NC88016 Necropsy(Autopsy)Macerated Stillborn 01/01/1994 NC88020 Necropsy(Autopsy)Gross Micro Wo Cns 01/01/1994 NC88025 Necropsy(Autopsy)Gross Micro W Brain 01/01/1994 NC88027 Necropsy(Autopsy)Gross Micro Brain Sp Cd 01/01/1994 NC




HCPCS CODE



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88028 Necropsy(Autopsy)Gross Micro Infnt W Brn 01/01/1994 NC88029 Necropsy(Autopsy)Gross Mic Still/Newborn 01/01/1994 NC88036 Necropsy(Autopsy)Ltd Gross/Nicro Regionl 01/01/1994 NC88037 Necropsy(Autopsy)Ltd Single Organ 01/01/1994 NC88040 Necropsy(Autopsy)Forensic Exam 01/01/1994 NC88045 Necropsy(Autopsy)Coroners Call 01/01/1994 NC88099 Unlisted Necropsy(Autopsy)Procedure 01/01/1994 NC88104 __ Cytopath Wash/Brush Ex.Cer/Vag. Interp. 04/01/2019 52.16 29.3188104 TC Cytopath Wash/Brush Ex.Cer/Vag. Interp. 04/01/2019 30.48 17.5888104 26 Cytopath Wash/Brush Ex.Cer/Vag. Interp. 04/01/2019 21.68 11.7288106 __ Cytopath Fluids Centrf Filter Method Int 04/01/2019 46.09 27.8888106 TC Cytopath Fluids Centrf Filter Method Int 04/01/2019 31.22 22.3188106 26 Cytopath Fluids Centrf Filter Method Int 04/01/2019 14.87 5.5888108 __ Cytopathology, Fluids, Washing Or Brush 04/01/2019 43.75 31.2088108 TC Cytopathology, Fluids, Washing Or Brush 04/01/2019 26.51 20.7588108 26 Cytopathology, Fluids, Washing Or Brush 04/01/2019 17.24 8.8988112 __ Cytopath, Cell Enhance Tech 04/01/2019 49.43 48.7288112 TC Cytopath, Cell Enhance Tech 04/01/2019 28.00 27.4588112 26 Cytopath, Cell Enhance Tech 04/01/2019 21.43 21.2788120 __ Cytp insitu hybrid urine spec 3-5 probes ea mnl 04/01/2019 449.38 201.5588120 TC Cytp insitu hybrid urine spec 3-5 probes ea mnl 04/01/2019 405.10 181.3988120 26 Cytp insitu hybrid urine spec 3-5 probes ea mnl 04/01/2019 44.28 20.1688121 __ Cytp insitu hybrid urne spec 3-5 probes cptr ea 04/01/2019 374.66 170.0788121 TC Cytp insitu hybrid urne spec 3-5 probes cptr ea 04/01/2019 336.74 153.0688121 26 Cytp insitu hybrid urne spec 3-5 probes cptr ea 04/01/2019 37.92 17.0188125 Cytopathology Forensic 10/01/1984 NC BR88130 Sex Chromatin Id; Barr Bodies 04/01/2019 14.98 15.4988140 Cytopath.Smears(Wbc)Chromosom Sex Determ 04/01/2019 6.66 8.2288141 Cytopath, cerv/vag interpretation 04/01/2019 23.66 20.1488142 Cytopath, cerv/vag thin layer preparation 04/01/2019 16.88 20.3688143 Cytopath. cerv/vag, thin layer, redo 04/01/2019 17.28 20.3688147 Cytopath. cerv/vag, automated 04/01/2019 37.92 10.8788148 Cytopath., cerv/vag, auto rescreening 04/01/2019 12.66 10.8788150 Cytopath Cerv/Vag(Pap)Screen Int <3 Smrs 04/01/2019 11.24 10.8788152 Cytopathology, cerv/vag automated 04/01/2019 20.73 10.8788153 Cytopathology, cerv/vag, redo 04/01/2019 18.02 10.8788154 Cytopathology, cerv/vag, selection 01/01/2018 D 12.9888155 Cytopath Cerv/Vag Hormon Evaluation 04/01/2019 10.99 6.1788160 __ Cytopath Other Source Screen Interpret 04/01/2019 52.04 24.6588160 TC Cytopath Other Source Screen Interpret 04/01/2019 32.21 14.7988160 26 Cytopath Other Source Screen Interpret 04/01/2019 19.82 9.8688161 __ Cytopathology, Any Other Source; 04/01/2019 47.33 25.7088161 TC Cytopathology, Any Other Source; 04/01/2019 28.25 15.4288161 26 Cytopathology, Any Other Source; 04/01/2019 19.08 10.2888162 __ Cyto; Other, Extended > 5 Slides' 04/01/2019 69.68 43.3288162 TC Cyto; Other, Extended > 5 Slides' 04/01/2019 40.16 25.9988162 26 Cyto; Other, Extended > 5 Slides' 04/01/2019 29.52 17.3388164 Cytopath, TBS, cerv/vag, manual 04/01/2019 11.24 10.8788165 Cytopath, TBS, cerv/vag, redo 04/01/2019 31.67 10.8788166 Cytopath, TBS, cerv/vag, auto redo 04/01/2019 11.24 10.8788167 Cytopath, TBS, cerv/vag, selection 04/01/2019 11.24 10.8788172 __ Evaluation Asp; Immed Cytohist Study 04/01/2019 42.04 34.6088172 TC Evaluation Asp; Immed Cytohist Study 04/01/2019 14.39 13.8488172 26 Evaluation Asp; Immed Cytohist Study 04/01/2019 27.65 20.7688173 __ Evaluation Asp; Cytohist Inter And Rpt 04/01/2019 111.55 67.7888173 TC Evaluation Asp; Cytohist Inter And Rpt 04/01/2019 57.24 33.8988173 26 Evaluation Asp; Cytohist Inter And Rpt 04/01/2019 54.31 33.8988174 Cytopath, c/v auto, in fluid 04/01/2019 19.03 20.9188175 Cytopath c/v auto fluid redo 04/01/2019 22.08 23.3688177 __ Cytp c/v auto thin lyr prepj adequacy ea eval 04/01/2019 22.40 12.5388177 TC Cytp c/v auto thin lyr prepj adequacy ea eval 04/01/2019 5.45 3.1388177 26 Cytp c/v auto thin lyr prepj adequacy ea eval 04/01/2019 16.94 9.4088182 __ Flow Cytometry; Cell Cycle Ordna 04/01/2019 93.74 45.0888182 TC Flow Cytometry; Cell Cycle Ordna 04/01/2019 64.20 31.5688182 26 Flow Cytometry; Cell Cycle Ordna 04/01/2019 29.54 13.5388184 Flowcytometry/ tc, 1 marker 04/01/2019 46.85 42.5388185 Flowcytometry/tc, add-on 04/01/2019 21.05 22.3388187 Flowcytometry/read, 2-8 04/01/2019 34.73 42.4988188 Flowcytometry/read, 9-15 04/01/2019 48.32 54.6788189 Flowcytometry/read, 16 & > 04/01/2019 64.70 67.6888199 __ Unlisted Cytopathology Procedure 01/01/2018 10.65 11.2188199 TC Unlisted Cytopathology Procedure 01/01/2018 2.66 2.8088199 26 Unlisted Cytopathology Procedure 01/01/2018 7.99 8.4188230 Tiss Cult Chromosome Anal;Lyphocyte 04/01/2019 97.08 119.8588233 Tiss Cult Chromosome;Skin/Solid Tiss Bio 04/01/2019 117.27 144.7888235 Tiss Cult Chromosome;Amnio Or Cv Cells 04/01/2019 122.72 151.5188237 Tiss Cult Chromosome;Bone Marrow Cells 04/01/2019 107.87 129.9588239 Tiss Cult Chromosome Anal;Other Tissure 04/01/2019 122.93 151.7788240 Cell cryopreservation/storage 04/01/2019 9.80 10.39




HCPCS CODE



TC -- Tech. comp.



CURRENT MAXIMUM




PREVIOUS MAXIMUM



88241 Frozen cell preparation 04/01/2019 9.07 10.3988245 Chromosome Break Synd;Sce 25,Cnt 5,1K Ba 04/01/2019 144.32 153.1588248 Chromosome Break Syn;Sce 100,Cnt 20,2K,Ba 04/01/2019 144.32 178.1688249 Chromosome Analysis, 100 04/01/2019 144.32 178.1688261 Chromosome Analysis Lymph 1-4 Cll Ikaryo 04/01/2019 198.26 181.8488262 Chromosome Analysis Lymph 1-20 Cll 2Karyo 04/01/2019 103.87 128.2488263 Chromosome;Cnt45,2 Karyotypes W Banding 04/01/2019 125.24 154.6288264 Chromosome Analysis, 20-25 04/01/2019 108.46 128.2488267 Chromosome Analysis Amniot 1-4Cll 1Karyo 04/01/2019 149.81 184.9688269 Chromosome,In Situ Amnio,Cnt6-12 Col,Ik 04/01/2019 138.61 171.1288271 Cytogenetics, DNA probe 04/01/2019 17.85 22.0488272 Cytogenetics, 3-5 04/01/2019 30.53 27.5588273 Cytogenetics, 10-30 04/01/2019 26.78 33.0588274 Cytogenetics, 25-99 04/01/2019 31.79 35.8188275 Cytogenetics, 100-300 04/01/2019 38.39 41.3288280 Chromosome Analysis Additional Karyotyp 04/01/2019 25.10 25.8288283 Chromosome;Add Banding,Spec Technique 04/01/2019 57.17 70.5888285 Chromosome Analysis Additional Cll Count 04/01/2019 20.18 19.5588289 Chromosome;Add High Resolution Study 04/01/2019 28.70 35.4288291 Cyto/Molecular report 04/01/2019 24.35 5.2688299 Unlisted Cytogenetic Study 01/01/2018 10.65 11.2188300 __ Level I Surg Path Gross Exam Only 04/01/2019 11.84 8.9388300 TC Level I Surg Path Gross Exam Only 04/01/2019 8.45 6.2588300 26 Level I Surg Path Gross Exam Only 04/01/2019 3.40 2.6888302 __ Level II Surg Path Gross & Micro Exam 04/01/2019 22.10 19.0588302 TC Level II Surg Path Gross & Micro Exam 04/01/2019 16.61 15.2488302 26 Level II Surg Path Gross & Micro Exam 04/01/2019 5.48 3.8188304 __ Level III Surg Path Gross & Micro Exam 04/01/2019 29.21 24.3288304 TC Level III Surg Path Gross & Micro Exam 04/01/2019 20.33 18.2488304 26 Level III Surg Path Gross & Micro Exam 04/01/2019 8.87 6.0888305 __ Level IV Surg Path Gross & Micro Exam 04/01/2019 49.83 48.2588305 TC Level IV Surg Path Gross & Micro Exam 04/01/2019 20.82 24.1288305 26 Level IV Surg Path Gross & Micro Exam 04/01/2019 29.01 24.1388307 __ Level V Surg Path Gross & Micro Exam 04/01/2019 188.97 89.7888307 TC Level V Surg Path Gross & Micro Exam 04/01/2019 125.33 62.8488307 26 Level V Surg Path Gross & Micro Exam 04/01/2019 63.64 26.9488309 __ Level VI Surg Path Gross & Micro Exam 04/01/2019 287.76 129.2488309 TC Level VI Surg Path Gross & Micro Exam 04/01/2019 174.87 90.4788309 26 Level VI Surg Path Gross & Micro Exam 04/01/2019 112.89 38.7788311 __ Surg Pathol Gr & Mc Decalcificat Proced 04/01/2019 16.12 12.6388311 TC Surg Pathol Gr & Mc Decalcificat Proced 04/01/2019 6.46 5.0588311 26 Surg Pathol Gr & Mc Decalcificat Proced 04/01/2019 9.66 7.5888312 __ Special Stains Group I For Microorganism 04/01/2019 69.44 34.8288312 TC Special Stains Group I For Microorganism 04/01/2019 49.04 24.3788312 26 Special Stains Group I For Microorganism 04/01/2019 20.40 10.4588313 __ Special Stains Group II Other 04/01/2019 50.04 25.1388313 TC Special Stains Group II Other 04/01/2019 40.88 20.1088313 26 Special Stains Group II Other 04/01/2019 9.17 5.0388314 __ Histochemical Staining wW/ Frozen Section 04/01/2019 60.85 38.0088314 TC Histochemical Staining wW/ Frozen Section 04/01/2019 43.60 26.6088314 26 Histochemical Staining wW/ Frozen Section 04/01/2019 17.25 11.4088319 __ Histochemistry To Id Enzyme Components 04/01/2019 62.99 58.7188319 TC Histochemistry To Id Enzyme Components 04/01/2019 42.61 41.1088319 26 Histochemistry To Id Enzyme Components 04/01/2019 20.38 17.6188321 Consult Report Referred Slides Prep Elsw 04/01/2019 75.70 64.07 36.05 27.3988323 __ Consult Report Referred Matrl w/ Slide Prep 04/01/2019 89.62 65.0888323 TC Consult Report Referred Matrl w/ Slide Prep 04/01/2019 23.05 26.0388323 26 Consult Report Referred Matrl w/ Slide Prep 04/01/2019 66.56 39.0588325 Surg Pathol, Comprehens Review & Detailed 04/01/2019 136.43 114.14 78.80 42.2488329 Consultation During Surgery 04/01/2019 38.06 27.66 28.00 15.3988331 __ Consult During Surgery w/ Frozen Section(s) 04/01/2019 71.03 62.7688331 TC Consult During Surgery w/ Frozen Section(s) 04/01/2019 22.80 25.1088331 26 Consult During Surgery w/ Frozen Section(s) 04/01/2019 48.22 37.6688332 __ Path consult intraop, addl 04/01/2019 38.60 32.4988332 TC Path consult intraop, addl 04/01/2019 14.88 9.7588332 26 Path consult intraop, addl 04/01/2019 23.72 22.7488333 __ Intraop cyto path consult, 1 04/01/2019 65.60 68.4688333 TC Intraop cyto path consult, 1 04/01/2019 17.36 23.1688333 26 Intraop cyto path consult, 1 04/01/2019 48.24 45.3088334 __ Intraop cyto path consult, 2 04/01/2019 40.61 40.9088334 TC Intraop cyto path consult, 2 04/01/2019 11.15 16.3688334 26 Intraop cyto path consult, 2 04/01/2019 29.46 24.5488341 __ Immunohisto antibody slide 04/01/2019 66.24 47.9488341 TC Immunohisto antibody slide 04/01/2019 44.57 31.7488341 26 Immunohisto antibody slide 04/01/2019 21.68 16.2088342 __ Immunohistochemistry Ea Antibody 04/01/2019 78.20 44.5688342 TC Immunohistochemistry Ea Antibody 04/01/2019 51.03 28.9788342 26 Immunohistochemistry Ea Antibody 04/01/2019 27.18 15.6088344 __ Immunohisto antibody slide 04/01/2019 124.40 83.43




HCPCS CODE



TC -- Tech. comp.



CURRENT MAXIMUM




PREVIOUS MAXIMUM



88344 TC Immunohisto antibody slide 04/01/2019 94.61 53.7188344 26 Immunohisto antibody slide 04/01/2019 29.79 29.7288346 __ Immunofluroescent Study, Each Antibody 04/01/2019 67.37 44.5188346 TC Immunofluroescent Study, Each Antibody 04/01/2019 39.89 26.7088346 26 Immunofluroescent Study, Each Antibody 04/01/2019 27.48 17.8088348 __ Electron Microscopy Diagnostic 04/01/2019 246.80 180.0288348 TC Electron Microscopy Diagnostic 04/01/2019 188.78 162.0188348 26 Electron Microscopy Diagnostic 04/01/2019 58.01 18.0088350 __ Immunofluor antb addl stain 04/01/2019 51.95 51.7788350 TC Immunofluor antb addl stain 04/01/2019 29.96 31.0688350 26 Immunofluor antb addl stain 04/01/2019 21.98 20.7188355 __ Morphometric Analysis;Skeletal Muscle 04/01/2019 96.05 103.7088355 TC Morphometric Analysis;Skeletal Muscle 04/01/2019 33.45 51.8588355 26 Morphometric Analysis;Skeletal Muscle 04/01/2019 62.60 51.8588356 __ Morphometric Analysis; Nerve 04/01/2019 160.70 152.3688356 TC Morphometric Analysis; Nerve 04/01/2019 65.93 76.1888356 26 Morphometric Analysis; Nerve 04/01/2019 94.77 76.1888358 __ Morphometric Analysis;Tumor 04/01/2019 68.54 65.0788358 TC Morphometric Analysis;Tumor 04/01/2019 32.96 32.5388358 26 Morphometric Analysis;Tumor 04/01/2019 35.60 32.5488360 __ Tumor immunohistochem/manual 04/01/2019 95.58 97.7888360 TC Tumor immunohistochem/manual 04/01/2019 61.67 58.6788360 26 Tumor immunohistochem/manual 04/01/2019 33.91 39.1188361 __ Immunohistochemistry, Tumor 04/01/2019 103.95 110.6788361 TC Immunohistochemistry, Tumor 04/01/2019 67.86 70.1188361 26 Immunohistochemistry, Tumor 04/01/2019 36.09 40.5688362 __ Nerve Teasing Preparations 04/01/2019 151.31 117.0988362 TC Nerve Teasing Preparations 04/01/2019 67.14 76.1088362 26 Nerve Teasing Preparations 04/01/2019 84.17 40.9888363 Exam & select archive tissue molecular analysis 04/01/2019 17.61 15.14 17.42 13.1588364 __ Insitu hybridization (fish) 04/01/2019 94.30 69.1688364 TC Insitu hybridization (fish) 04/01/2019 67.61 48.9788364 26 Insitu hybridization (fish) 04/01/2019 26.68 20.1988365 __ Tiss In Situ Hybridiz, Interprt + Report 04/01/2019 128.08 53.9688365 TC Tiss In Situ Hybridiz, Interprt + Report 04/01/2019 94.36 35.0788365 26 Tiss In Situ Hybridiz, Interprt + Report 04/01/2019 33.72 18.8988366 __ Insitu hybridization (fish) 04/01/2019 186.99 106.9688366 TC Insitu hybridization (fish) 04/01/2019 139.42 60.2188366 26 Insitu hybridization (fish) 04/01/2019 47.57 46.7588367 __ Insitu hybridization, auto 04/01/2019 76.76 75.5388367 TC Insitu hybridization, auto 04/01/2019 50.29 48.9488367 26 Insitu hybridization, auto 04/01/2019 26.47 26.5988368 __ Insitu hybridization, manual 04/01/2019 86.73 83.5388368 TC Insitu hybridization, manual 04/01/2019 54.99 52.4188368 26 Insitu hybridization, manual 04/01/2019 31.74 31.1288369 __ M/phmtrc alysishquant/semiq 04/01/2019 78.18 52.6888369 TC M/phmtrc alysishquant/semiq 04/01/2019 53.51 33.9988369 26 M/phmtrc alysishquant/semiq 04/01/2019 24.68 18.6988371 Protein; western blot, tissue, w/intp & rept 04/01/2019 18.53 17.7788371 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6988372 Protein; western blot, tissue, w/intp & rept, immun probe 04/01/2019 19.67 18.80

88372 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6988373 __ M/phmtrc alys ishquant/semiq 04/01/2019 56.38 42.9688373 TC M/phmtrc alys ishquant/semiq 04/01/2019 35.41 27.2588373 26 M/phmtrc alys ishquant/semiq 04/01/2019 20.98 15.7188374 __ M/phmtrc alys ishquant/semiq 04/01/2019 243.53 145.2488374 TC M/phmtrc alys ishquant/semiq 04/01/2019 209.98 111.6688374 26 M/phmtrc alys ishquant/semiq 04/01/2019 33.55 33.5788375 Optical endomicroscpy interp 04/01/2019 37.82 34.4988377 __ M/phmtrc alys ishquant/semiq 04/01/2019 290.06 152.7888377 TC M/phmtrc alys ishquant/semiq 04/01/2019 241.20 103.9388377 26 M/phmtrc alys ishquant/semiq 04/01/2019 48.86 48.8588380 __ Microdissection 04/01/2019 98.66 4.7588380 TC Microdissection 04/01/2019 56.75 2.3788380 26 Microdissection 04/01/2019 41.91 2.3888381 __ Microdissection, manual 04/01/2019 87.03 85.3888381 TC Microdissection, manual 04/01/2019 67.89 55.5088381 26 Microdissection, manual 04/01/2019 19.14 29.8888387 __ Tiss exam molecular study 04/01/2019 25.81 25.3888387 TC Tiss exam molecular study 04/01/2019 4.23 5.0788387 26 Tiss exam molecular study 04/01/2019 21.57 20.3188388 __ Tiss ex molecul study add-on 04/01/2019 25.20 15.3288388 TC Tiss ex molecul study add-on 04/01/2019 6.95 4.5988388 26 Tiss ex molecul study add-on 04/01/2019 18.24 10.7388399 __ Unlisted Surgical Pathology Procedure 01/01/2018 10.09 11.2188399 TC Unlisted Surgical Pathology Procedure 01/01/2018 2.52 2.8088399 26 Unlisted Surgical Pathology Procedure 01/01/2018 7.57 8.4188720 Bilirubin, Total, Transcutaneous 04/01/2019 4.18 4.16




HCPCS CODE



TC -- Tech. comp.



CURRENT MAXIMUM




PREVIOUS MAXIMUM



88738 Hgb quant transcutaneous 04/01/2019 4.18 4.1688740 Hemoglobin, Qnt, Transq, /Day; Carboxy- 04/01/2019 7.03 4.1688741 Hemoglobin, Qnt, Transq, /Day; Met- 04/01/2019 7.03 4.1688749 Unlisted in vivo lab service 01/01/2018 4.99 5.5489049 Chct for mal hyperthermia 04/01/2019 173.66 46.89 164.28 49.4889050 Cell Count,Miscell.Fluid Not Bld. 04/01/2019 3.94 3.9289051 Cell Count,Miscell.Fluid Not Bld,Differ 04/01/2019 4.59 5.6689055 Leukocyte assessment, fecal 04/01/2019 3.56 4.4089060 Crystal ident by light microscopy, tissue/fluid (exc urine) 04/01/2019 5.96 7.36

89060 26 [Clinical pathol interp, reported w/ modifier 26] 04/01/2019 13.63 13.6989125 Fat Stain Feces Urine Sputum 04/01/2019 4.41 4.4589160 Meat Fibers Feces 04/01/2019 3.64 1.6189190 Nasal Smear For Eosinophils 04/01/2019 4.34 3.4489220 Sputum Specimen Collection 01/01/2004 NC89230 Collect Sweat For Test 04/01/2019 2.50 2.2589240 Pathology Lab Procedure 01/01/2018 10.09 11.2189250 Culture & fertilization of oocyte(s) 01/01/1996 NC89251 Culture of oocytes with embryos 01/01/1998 NC89253 Assisted embryo hatching 01/01/1998 NC89254 Oocyte identification 01/01/1998 NC89255 Preparation of embryo for transfer 01/01/1998 NC89257 Sperm identification 01/01/1998 NC89258 Cryopreservation of embryo 01/01/1998 NC89259 Cryopreservation of sperm 01/01/1998 NC89260 Sperm isolation 01/01/1998 NC89261 Sperm isolation 01/01/1998 NC89264 Sperm tissue identification 01/01/1999 NC89268 Insemination Of Oocytes 01/01/2004 NC89272 Extended Culture Of Oocytes 01/01/2004 NC89280 Assist Oocyte Fertilization 01/01/2004 NC89281 Assist Oocyte Fertilization 01/01/2004 NC89290 Biopsy, Oocyte Polar Body 01/01/2004 NC89291 Biopsy, Oocyte Polar Body 01/01/2004 NC89300 Semen Analysis-Sperm/Motility(+Huhner) 04/01/2017 NC 11.6589310 Semen Analysis Motility + Count 04/01/2017 NC 10.4789320 Semen Analysis Complete Vol Cnt Mot Diff 04/01/2017 NC 15.7489321 Semen analysis 01/01/2001 NC89322 Semen analysis, strict criteria 01/01/2008 NC89323 Sperm Immobilization 01/01/1994 NC89325 Sperm Agglutination W Antibody Titer 04/01/2017 NC 5.9689329 Sperm Evaluation;Hamster Penetration 04/01/2017 NC 27.3889330 Cervical Mucus Penetration Test 04/01/2017 NC 12.9289331 Retrograde ejaculation analysis 01/01/2008 NC89335 Cryopreserve Testicular Tiss 01/01/2004 NC89337 Cryopreservation oocyte(s) 01/01/2015 NC89342 Storage/Year; Embryo(S) 01/01/2004 NC89343 Storage/Year; Sperm/Semen 01/01/2004 NC89344 Storage/Year; Reprod Tissue 01/01/2004 NC89346 Storage/Year; Oocyte 01/01/2004 NC89352 Thawing Cryopresrved; Embryo 01/01/2004 NC89353 Thawing Cryopresrved; Sperm 01/01/2004 NC89354 Thaw Cryoprsvrd; Reprod Tiss 01/01/2004 NC89356 Thawing Cryopresrved; Oocyte 01/01/2004 NC89398 Unlisted reprod med lab proc 01/01/2018 9.90 10.42G2023 Specimen collection COVID 19 03/01/2020 23.46G2024 Specimen collection SNF/LAB COVID 19 03/01/2020 25.46G0452 26 Molecular pathology interpretation [reported w/ modifier

26]04/01/2014 11.01 11.59

G0472 Hep C screen high risk/other 01/01/2015 BRG0477 QW Drug test presump optical [Reported with modifier QW] 01/01/2018 D 8.83G0478 Drug test presump opt inst 01/01/2016 D NCG0479 Drug test presump not opt 01/01/2016 D NCG0480 Drug test def 1-7 classes 01/01/2016 NCG0481 Drug test def 8-14 classes 01/01/2016 NCG0482 Drug test def 15-21 classes 01/01/2016 NCG0483 Drug test def 22+ classes 01/01/2016 NCP9612 Catheter Collection, Single Patient 01/01/2018 2.25 2.91P9615 Cath-Coll. Spec Noff, Ind Lab Mult Pt, LTCF 01/01/2018 2.25 3.00Q0091 Obtaining screen pap smear 04/01/2019 32.02 14.69 30.55 13.95Q0092 Set up port xray equipment 01/01/2004 NCQ0111 Wet Mounts 04/01/2019 11.24 4.40Q0112 Potassium Hydroxide Preps 04/01/2019 4.37 4.40Q0113 Pinworms Examinations 04/01/2019 3.56 5.57Q0114 Fern Test 04/01/2019 7.31 7.36Q0115 Post-coital mucus exam 01/01/2004 NCU0001 2019-ncov diagnostic p 03/01/2020 35.92U0002 Covid-19 lab test non-cdc 03/01/2020 51.31




HCPCS CODE



TC -- Tech. comp.



CURRENT MAXIMUM




PREVIOUS MAXIMUM



U0003 SARS COVID 19 Highthruput 04/14/2020 100.00U0004 SARS COVID 19 Highthruput 04/14/2020 100.00




HCPCS CODE



TC -- Tech. comp.



CURRENT MAXIMUM




PREVIOUS MAXIMUM



DISCONTINUED PROCEDURE CODES80100 Drug screen; multiple drug classes, each proc 01/01/2015 D80101 Drug screen; single drug class, each drug class 01/01/2015 D80102 Drug, confirmation, each procedure 01/01/2015 D80103 Drug analysis, tissue prep 01/01/2015 D80104 Drug screen; qual 1+ class, nonchromat, each 01/01/2015 D80152 Amitriptyline 01/01/2015 D80154 Benzodiazepines 01/01/2015 D80160 Desipramine 01/01/2015 D80166 Doxepin 01/01/2015 D80172 Gold 01/01/2015 D80174 Imipramine 01/01/2015 D80182 Nortrptyline 01/01/2015 D80196 Salicylate 01/01/2015 D80300 Drug screen 01/01/2017 D80301 Drug screen 01/01/2017 D80302 Drug screen 01/01/2017 D80303 Drug Screen 01/01/2017 D80304 Drug screen 01/01/2017 D80440 Trh Stimulation Panel 01/01/2015 D81280 Long qt synd gene full seq 01/01/2017 D81281 Long qt synd known fam var 01/01/2017 D81282 Long qt syn gene dup/dlt var 01/01/2017 D82000 Acetaldehyde blood 01/01/2015 D82003 Acetaminophen 01/01/2015 D82055 Alcohol (Ethanol) Any Spec But Breath 01/01/2015 D82101 Alkaloids, Urine, Quantitive 01/01/2015 D82145 Amphetamine, Or Methamphetamine 01/01/2015 D82205 Barbiturates Blood Quantitative 01/01/2015 D82307 Calciferol (Vitamin D) 01/01/2010 D82486 Chromatography,Qual;Column Analytc Nes 01/01/2016 D82487 Chromatography Qual;Paper 1 Analytc Nes 01/01/2016 D82488 Chromatography Qual;Paper 2 Analytc Nes 01/01/2016 D82489 Chromatography Thin Layer,Analytc Nes 01/01/2016 D82491 Chromatography,Quant;Column Analyte Nes 01/01/2016 D82492 Chromatography, quant., column; mult. analytes 01/01/2016 D82520 Cocaine Or Metabolite 01/01/2015 D82541 Column chromatography/mass spectrometry 01/01/2016 D82543 Column chromatography/mass spectrometry 01/01/2016 D82544 Column chromatography/mass spectrometry 01/01/2016 D82646 Dihydrocodeinone 01/01/2015 D82649 Dihydromorphinone 01/01/2015 D82651 Dihydrotestosterone Dht 01/01/2015 D82654 Dimethadione 01/01/2015 D82666 Epiandrosterone 01/01/2015 D82690 Ethchlorvynol 01/01/2015 D82742 Flurazepam 01/01/2015 D82926 Gastric Acid Free And Total Ea Ch Spec 01/01/2011 D82928 Gastric Acid, Free Or Total; Each Spec 01/01/2011 D82953 Glucose Tolbutamide Tolerance Test 01/01/2015 D82975 Glutamine (Glutamicacidamide) 01/01/2015 D82980 Glutethimide 01/01/2015 D83008 Guanosine Monophophate (Gmp) Cyclic 01/01/2015 D83055 Hemoglobin; Sulfhemoglobin, Quantitative 01/01/2015 D83071 Hemosiderin; Quantitative 01/01/2015 D83634 Lactose, Urine; Quantitative 01/01/2015 D83788 Mass spectrometry, qualitative 01/01/2016 D83805 Meprobamate 01/01/2015 D83840 Methadone 01/01/2015 D83858 Methsuximide 01/01/2015 D83866 Mucopolysaccharides Acid; Screen 01/01/2015 D83887 Nicotine 01/01/2015 D83890 Nuclear Molecular Diag;Isolation Or Ext 01/01/2013 D83891 Molecule Isolate Nucleic 01/01/2013 D83892 Nuclear Molecular Iag;Enzymatic Or Ext 01/01/2013 D83893 Molecular dot/slot blot 01/01/2013 D83894 Nuclear Molecular Iag;Separation 01/01/2013 D83896 Nuclear Molecular Diag;Nucleic Probe,Ea 01/01/2013 D83897 Molecule Nucleic Transfer 01/01/2013 D83898 Nuclear Molecular Diag;Amp Nulceic Adic 01/01/2013 D83900 Molecule nucleic ampli 2 seq 01/01/2013 D83901 Molecule Nucleic Amp. 01/01/2013 D83902 Molecular diagnosistics, reverse transcription 01/01/2013 D83903 Molecule Mutation Scan 01/01/2013 D83904 Molecule Mutation Identify 01/01/2013 D83905 Molecule Mutation Identify 01/01/2013 D83906 Molecule Mutation Identify 01/01/2013 D83907 Lyse cells for nucleic ext 01/01/2013 D83908 Nucleic acid, signal ampli 01/01/2013 D




HCPCS CODE



TC -- Tech. comp.



CURRENT MAXIMUM




PREVIOUS MAXIMUM



83909 Nucleic acid, high resolute 01/01/2013 D83912 Nucleic Acid Probe,Interp. & Report 01/01/2013 D83912 26 [Clinical pathol interp, reported w/ modifier 26] 01/01/2013 D83913 Molecular, rna stabilization 01/01/2013 D83914 Mutation ident ola/sbce/aspe 01/01/2013 D83925 Opiates,(E.G., Morphine Meperidine) 01/01/2015 D84022 Phenothiazine 01/01/2015 D84127 Porphyrins,Feces;Qualitative 01/01/2015 D86781 Ab;Treponema Pallidum,Confirmatory T 01/01/2010 D86903 Ag Screen For Blood Using Reag,Per Unit 01/01/2011 D87001 Animal Inoculation Small W Observation 01/01/2015 D87198 Cytomegalovirus antibody (DFA) 05/01/2008 D87199 Enterovirus antibody (DFA) 05/01/2008 D87620 HPV by DNA, direct probe 01/01/2015 D87621 HPV by DNA, amplified probe 01/01/2015 D87622 HPV by DNA, quantification 01/01/2015 D88107 __ Cytopath Fluids Centrf Smears Filter Prp 01/01/2012 D88107 26 Cytopath Fluids Centrf Smears Filter Prp 01/01/2012 D88107 TC Cytopath Fluids Centrf Smears Filter Prp 01/01/2012 D88318 Histochemistry To Id Chemical Components 01/01/2012 D88343 __ Immunohisto antibody add slide 01/01/2015 D88343 26 Immunohisto antibody add slide 01/01/2015 D88343 TC Immunohisto antibody add slide 01/01/2015 D88347 __ Immunofluroescent Study,Each Ab;Indirect 01/01/2016 D88347 26 Immunofluroescent Study,Each Ab;Indirect 01/01/2016 D88347 TC Immunofluroescent Study,Each Ab;Indirect 01/01/2016 D88349 __ Electron Microscopy Scanning 01/01/2015 D88349 26 Electron Microscopy Scanning 01/01/2015 D88349 TC Electron Microscopy Scanning 01/01/2015 D88384 Eval molecular probes, 11-50 01/01/2013 D88385 Eval molecul probes, 51-250 01/01/2013 D88386 Eval molecul probes, 251-500 01/01/2013 D88400 Bilirubin total transcut 01/01/2009 D89100 Duodenal Intubation + Aspiration,Sing 01/01/2011 D89105 Duodenal Intub & Aspir; Mult 01/01/2011 D89130 Gastric Intubation And Aspiration 01/01/2011 D89132 Gastric Intubation Aspirat W Stimulation 01/01/2011 D89135 Gastric Intub Aspir Fractnl Coll 1 Hour 01/01/2011 D89136 Gastric Intub Aspir Fractnl Coll 2.Hour 01/01/2011 D89140 Gastric Intub Aspr Frtnl 2 Hrs Stimulatn 01/01/2011 D89141 Gastric Intub Aspr Frtnl 3 Hrs Stimulatn 01/01/2011 D89225 Starch Granules, Feces 01/01/2011 D89235 Water Load Test 01/01/2011 DG0431 Drug screen; high-complex test, per encounter 01/01/2016 DG0434 Drug screen; waived/mod-complex test, per encounter 01/01/2016 DQ0095 Urine Preg Tests; Screening Kits 12/07/2010 DQ0097 Hemoglobin, Cooper Sulfate, Nonautomated 01/01/2001 DQ0098 Blood Glucose; Waivered Method 01/01/2001 DQ0099 Fecal Occult Blood 01/01/2001 DQ0100 Dipstick Urine;One Or More Components 01/01/2001 DQ0101 Spun Microhematocrit 01/01/2001 DQ0102 Erythocytc Sedimentation Rate 01/01/2001 D

clinical diagnostic and pathology procedures...80322 alcohols levels 01/01/2018 13.27 14.74 80323...

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