CPT code 80055: Obstetric panel, without HIV testing2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A prenatal blood test panel combining blood count, blood typing, antibody screening, and infection-related tests when a complete obstetric panel is performed.
Medicare pays $47.81 for 80055 under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$47.81
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 8 sections
What 80055 covers
This blood-testing panel brings together a complete blood count with white-cell differential, hepatitis B surface antigen, rubella antibody, a qualitative non-treponemal syphilis test, a red blood cell antibody screen, and ABO and Rh(D) blood typing. It is commonly ordered during prenatal care by obstetric clinicians and performed by a clinical laboratory. The blood count may use an automated differential or an appropriate manual differential, depending on the testing performed.
Report 80055 when the complete set of panel tests is performed; it represents the panel rather than a count of its individual tests. The 2026 national CLFS amount is $47.81, unchanged from 2020 through 2026. Medicare pays one national amount per code in every locality, with no geographic adjustment or office-versus-facility difference. The service is paid only under the CLFS, not the physician fee schedule.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 80055
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 80055. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Excluded from the physician fee schedule
The physician fee schedule lists 80055 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80055 on the lab fee schedule since 2020
80055 · CLFS 2026 Q4 (current)
$47.81
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
80055 compared with similar tests
- 80081Obstetric panelIncludes HIV testing$74.86
- This related obstetric panel includes HIV testing; 80055 is the obstetric panel without that addition.
- 80050General health panelFour-test combinationNo national amount
- 80050 is a general health panel, not the prenatal test combination represented by 80055.
- 80074Hepatitis panelFour viral markers$47.63
- 80074 is an acute hepatitis panel. 80055 includes hepatitis B surface antigen as one part of a broader obstetric panel.
80055 billing questions
When should 80055 be reported?
Report it when the complete obstetric panel is performed, including its blood count and differential, infection-related tests, antibody screen, and ABO/Rh typing.
How does 80055 differ from 80081?
80081 is the related obstetric panel that includes HIV testing. Use the panel matching the tests performed.
Can the individual tests also be reported with 80055?
The panel represents its specified tests as a single panel service. When the complete panel is not performed, report the individual tests that were performed instead.
How many units should be reported?
Report one unit for each completed obstetric panel; the panel's multiple tests do not create multiple units.
How does Medicare pay for 80055?
Medicare pays the code under the CLFS at one national amount, with no locality or office-versus-facility adjustment.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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