CPT code 80167: Felbamate assay, drug concentration2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures felbamate concentration in a patient receiving felbamate therapy, supporting clinical assessment of drug exposure during epilepsy treatment.
Medicare pays $18.64 for 80167 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
$18.64
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2021
- 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 80167 covers
A clinical laboratory measures felbamate concentration in a serum specimen from a patient receiving felbamate, typically for seizure treatment. Neurologists and other clinicians managing antiseizure therapy may order the assay when reviewing drug exposure, including after a dose change or when treatment response or tolerability prompts reassessment. Hospital and independent laboratories perform the measurement.
Report 80167 for the felbamate assay rather than an assay for another antiseizure medication. Medicare pays the service only under the CLFS. The 2026 national CLFS amount is $18.64, with the same amount in every locality and no office-versus-facility difference; it has remained unchanged from 2021 through 2026. The code 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 80167
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 80167. 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 80167 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80167 on the lab fee schedule since 2021
80167 · CLFS 2026 Q4 (current)
$18.64
Unchanged since Jan 1, 2021
24 quarterly CLFS releases on file, first CLFS 2021 Q1. A code missing from a quarter wasn’t on that release.
80167 compared with similar tests
- 80168Ethosuximide level$16.34
- 80168 measures ethosuximide; 80167 measures felbamate. Choose according to the medication tested.
- 80164Valproate levelTotal concentration$13.54
- 80164 measures total valproic acid, while 80167 measures felbamate. The drug being measured determines the code.
- 80156Carbamazepine levelTotal concentration$14.57
- 80156 is for carbamazepine measurement. Use 80167 only when the assay measures felbamate.
80167 billing questions
When should 80167 be chosen instead of another antiseizure drug assay?
Use 80167 when the laboratory measures felbamate. Select a drug-specific assay code when the measured medication is a different antiseizure drug.
Is 80167 paid under the CLFS or physician fee schedule?
Medicare pays 80167 only under the CLFS. It is excluded from the physician fee schedule.
Does the CLFS amount vary by locality or setting?
No. Medicare uses one national amount for the code across localities, without an office-versus-facility difference.
What does 80167 measure?
It measures felbamate concentration. Use the drug-specific assay code for a different medication.
Can 80167 be used for a different antiseizure medication?
No. The assay is specific to felbamate; use the code for the medication actually 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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