CPT code 80145: Adalimumab assay, drug concentration2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures adalimumab concentration in a patient specimen, commonly to assess drug exposure during treatment for inflammatory disease or loss of response.
Medicare pays $38.57 for 80145 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
$38.57
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 80145 covers
This laboratory assay measures adalimumab, a biologic medication used to treat inflammatory conditions such as rheumatoid arthritis, inflammatory bowel disease, and psoriasis. Clinicians may order it when evaluating treatment response, suspected inadequate drug exposure, or loss of response. The test is performed by a laboratory on a blood specimen, commonly serum. It measures the drug concentration, not antibodies directed against adalimumab.
Report 80145 for the adalimumab assay. The 2026 national CLFS amount is $38.57, unchanged since 2020. Medicare pays one CLFS amount per code nationwide, without locality or office-versus-facility adjustment. The test is paid through the CLFS; it has no separate physician fee schedule payment.
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 80145
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 80145. 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 80145 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80145 on the lab fee schedule since 2020
80145 · CLFS 2026 Q4 (current)
$38.57
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.
80145 compared with similar tests
- 80230Infliximab assayDrug measurement$38.57
- Use 80145 for adalimumab concentration and 80230 for infliximab concentration. The measured medication determines the code.
- 80299Drug assayUnlisted therapeutic drug$18.64
- 80145 is the specific assay code for adalimumab. 80299 is an unlisted therapeutic drug assay code for an analyte without a specific code.
80145 billing questions
Does 80145 measure adalimumab or antibodies to the drug?
It measures the adalimumab concentration. An assay for antibodies directed against adalimumab is a different test.
When might a clinician order this assay?
It may be ordered to assess drug exposure during treatment, including when response is inadequate or has diminished.
What specimen is used?
The assay is performed on a blood specimen, commonly serum. Follow the performing laboratory’s collection and handling instructions.
Is 80145 paid under the physician fee schedule?
No. Medicare pays this test through the CLFS, with one national amount per code and no locality or office-versus-facility adjustment.
How is 80145 distinguished from 80230?
80145 measures adalimumab; 80230 is the assay for infliximab. Select the code for the biologic drug being measured.
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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