CPT code 80155: Caffeine assay, caffeine concentration2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Laboratory assay measuring caffeine concentration, reported when a patient's caffeine level is tested for clinical assessment.
Medicare pays $38.57 for 80155 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 7 sections
What 80155 covers
80155 is the laboratory assay for measuring caffeine concentration. It identifies caffeine as the analyte, so it is selected when the test performed measures caffeine rather than another medication. The result is a caffeine level for clinical assessment; it is not a code for an assay of acetaminophen, carbamazepine, or another drug. The code distinguishes the analyte being measured.
Report 80155 for the caffeine assay performed. Medicare pays this test only through the CLFS. CMS sets one national amount for all states and localities, without geographic adjustment or a different office-versus-facility amount. The 2026 national CLFS amount is $38.57, unchanged from 2020 through 2026. The test is excluded from 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 80155
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 80155. 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 80155 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80155 on the lab fee schedule since 2020
80155 · 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.
80155 compared with similar tests
- 80143Acetaminophen assay$18.64
- 80143 measures acetaminophen, while 80155 measures caffeine. Select the code for the substance assayed.
- 80156Carbamazepine levelTotal concentration$14.57
- 80156 measures total carbamazepine; 80155 measures caffeine. Choose based on the analyte.
- 80157Carbamazepine levelUnbound carbamazepine$13.25
- 80157 measures free carbamazepine, not caffeine. Choose based on the analyte and, for carbamazepine, the fraction measured.
80155 billing questions
What does 80155 measure?
It identifies a laboratory assay measuring caffeine concentration.
How does 80155 differ from 80143?
80155 measures caffeine; 80143 measures acetaminophen. Select the code for the substance assayed.
How does 80155 differ from the carbamazepine assays?
80155 measures caffeine. Codes 80156 and 80157 identify assays of total and free carbamazepine, respectively.
How does Medicare pay for 80155?
Medicare pays it only under the CLFS, using one national amount across localities and without an office-versus-facility payment difference.
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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