CPT code 80162: Digoxin assay, total concentration2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures total digoxin in blood to monitor therapy or evaluate suspected inadequate or excessive drug levels in patients receiving digoxin.
Medicare pays $13.28 for 80162 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
$13.28
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 80162 covers
Code 80162 identifies laboratory measurement of total digoxin in a blood specimen, generally serum. Clinicians use the result to monitor patients receiving digoxin and to assess suspected inadequate or excessive levels, including when symptoms, medication changes, or clinical status prompt reassessment. It measures total rather than free digoxin. Treating clinicians order the test, and clinical laboratories perform and report it.
Report 80162 for the total assay performed; a free digoxin measurement is a separate test reported with 80163. Medicare pays 80162 only through the CLFS. The 2026 national CLFS amount is $13.28, unchanged since 2020. One national amount applies across states and localities, without geographic adjustment or an office-versus-facility difference.
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 80162
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 80162. 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 80162 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80162 on the lab fee schedule since 2020
80162 · CLFS 2026 Q4 (current)
$13.28
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.
80162 compared with similar tests
80162 billing questions
When should 80162 be used instead of 80163?
Use 80162 for a total digoxin measurement. Use 80163 when the assay measures free digoxin.
Does 80162 include a free digoxin result?
No. It reports total digoxin; a free digoxin measurement is a distinct assay reported with 80163.
How does Medicare pay for 80162?
Medicare pays the test under the CLFS at one national amount. The amount is the same across localities and does not differ between office and facility settings.
What clinical situation commonly prompts this assay?
Clinicians commonly order it to monitor a patient taking digoxin or to evaluate a suspected inadequate or excessive digoxin level.
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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