CPT code 80158: Cyclosporine assay, therapeutic drug monitoring2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures cyclosporine concentration to support immunosuppressive therapy monitoring, commonly for patients receiving treatment after organ transplantation.
Medicare pays $18.05 for 80158 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
$18.05
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 80158 covers
This laboratory assay measures cyclosporine concentration to help clinicians monitor immunosuppressive treatment, especially after organ transplantation. It is commonly ordered by transplant teams and other clinicians managing cyclosporine therapy. Testing is generally performed on a blood specimen, typically whole blood, by a clinical laboratory; the result helps the treating clinician assess drug exposure and guide medication management.
Report 80158 for the cyclosporine assay performed, rather than an assay for another immunosuppressant. Medicare pays the test only under the CLFS. The 2026 national CLFS amount is $18.05, unchanged from 2020 through 2026; the same amount applies across states and localities, without a geographic or office-versus-facility adjustment. The code is excluded from the physician fee schedule, so Medicare payment for the test comes from the CLFS.
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 80158
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 80158. 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 80158 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80158 on the lab fee schedule since 2020
80158 · CLFS 2026 Q4 (current)
$18.05
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.
80158 compared with similar tests
- 80197Drug levelTacrolimus concentration$13.73
- 80197 measures tacrolimus. Use it when tacrolimus is the drug being monitored; 80158 measures cyclosporine.
- 80169Everolimus levelImmunosuppressant monitoring$13.73
- 80169 measures everolimus rather than cyclosporine. Choose the code for the medication whose concentration the laboratory measures.
- 80195Sirolimus levelWhole-blood drug level$13.73
- 80195 measures sirolimus. It is not interchangeable with 80158 when cyclosporine is the analyte.
80158 billing questions
When should 80158 be selected instead of another drug assay?
Use 80158 when the laboratory measures cyclosporine. Select the assay code for the specific medication being measured when monitoring another immunosuppressant.
Is cyclosporine monitoring commonly performed after transplantation?
Yes. Transplant clinicians commonly order the assay to monitor cyclosporine treatment.
What specimen is typically used?
Cyclosporine monitoring is generally performed on blood, typically whole blood.
Does Medicare pay 80158 under the physician fee schedule?
No. Medicare pays this test under the CLFS; it is excluded from the physician fee schedule.
What should the record support?
The order and laboratory record should identify cyclosporine as the analyte and document the assay performed and its result.
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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