CPT code 80061: Lipid panel, cholesterol and triglycerides2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A blood test measuring total cholesterol, HDL cholesterol, and triglycerides, reported together to assess or monitor a patient’s lipid status.
Medicare pays $13.39 for 80061 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
$13.39
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
- QW · CLIA-waived test
- $13.39
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 80061 covers
A lipid panel measures total cholesterol, HDL cholesterol, and triglycerides from a blood specimen. Clinicians commonly order it to assess lipid status and cardiovascular risk or to monitor a patient with dyslipidemia or lipid-lowering treatment. Clinical laboratories and qualifying physician-office laboratories perform and report the panel. The panel code represents the listed tests performed together, rather than separate reporting of each component for the same panel.
Report 80061 once for the panel, not once per analyte. CMS also recognizes a CLIA-waived version with modifier QW for sites holding a CLIA certificate of waiver. Medicare pays the test through the CLFS, not the physician fee schedule. The 2026 national CLFS amount is $13.39, unchanged from 2020 through 2026; the same amount applies in every locality, without a geographic or office/facility adjustment.
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 80061
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 80061. 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 80061 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 80061 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $13.39.
80061 on the lab fee schedule since 2020
80061 · CLFS 2026 Q4 (current)
$13.39
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.
80061 compared with similar tests
- 82465CholesterolTotal, serum or whole blood$4.35
- 82465 reports total cholesterol alone. Use 80061 when the panel’s total cholesterol, HDL cholesterol, and triglyceride measurements are performed together.
- 83718HDL cholesterolDirect measurement$8.19
- 83718 reports HDL cholesterol alone. It does not represent the complete lipid panel.
- 84478TriglyceridesIndividual measurement$5.74
- 84478 reports triglycerides alone. Use 80061 for the combined lipid panel.
- 83721LDL cholesterolDirect LDL measurement$10.50
- 83721 represents a direct LDL measurement. It is distinct from 80061 and may be reported with the panel when direct LDL testing is performed.
80061 billing questions
When should 80061 be reported instead of a single-analyte cholesterol test?
Report 80061 when the panel’s cholesterol and triglyceride measurements are performed together. A single-analyte code is for testing only that individual analyte, not a substitute for the completed panel.
Should the panel components also be billed separately?
Do not separately report the component tests as duplicate services when they were performed as part of the lipid panel. Individual analyte codes apply when those tests are performed separately.
When is modifier QW appropriate?
Use QW for the CLIA-waived version when the testing site holds a CLIA certificate of waiver.
How many units should be reported for one lipid panel?
Report one unit for one completed panel, rather than a unit for each measured component.
How does Medicare pay for 80061?
Medicare pays 80061 under the CLFS. The national amount is the same across localities and does not vary by office or facility setting.
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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