CPT code 80180: Mycophenolate level, quantitative assay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A quantitative mycophenolic acid assay measures drug concentration, commonly to monitor patients receiving mycophenolate after organ transplantation.
Medicare pays $18.05 for 80180 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 7 sections
What 80180 covers
This laboratory assay measures mycophenolic acid, the active metabolite associated with mycophenolate therapy. It is commonly ordered for therapeutic drug monitoring in transplant recipients taking mycophenolate mofetil or mycophenolate sodium, including when clinicians assess drug exposure alongside the patient’s clinical response or possible toxicity. Clinical laboratories perform and report the test for ordering transplant and other treating providers.
Report the assay for mycophenolic acid rather than for the prescribed dose or a different immunosuppressant. Medicare pays the test only under the Clinical Laboratory Fee Schedule (CLFS), at one national amount across localities with no office-versus-facility difference. The 2026 national CLFS amount is $18.05, 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 80180
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 80180. 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 80180 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80180 on the lab fee schedule since 2020
80180 · 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.
80180 compared with similar tests
- 80169Everolimus levelImmunosuppressant monitoring$13.73
- 80169 measures everolimus, not mycophenolic acid. Choose according to the drug analyzed.
- 80195Sirolimus levelWhole-blood drug level$13.73
- 80195 measures sirolimus. It is not a substitute for a mycophenolic acid assay.
- 80197Drug levelTacrolimus concentration$13.73
- 80197 measures tacrolimus. Report 80180 when the laboratory assay is for mycophenolic acid.
80180 billing questions
When is this assay ordered?
It is commonly used to monitor mycophenolic acid exposure in patients taking mycophenolate, especially after organ transplantation. The measured drug must be mycophenolic acid.
How does this differ from an everolimus assay?
Code 80180 measures mycophenolic acid; code 80169 measures everolimus. Select the code for the drug actually assayed.
Is reporting based on the prescribed dose?
No. The code identifies a laboratory assay for mycophenolic acid, not a medication dose.
How does Medicare pay for this test?
Medicare pays it under the CLFS at one national amount, with no locality or office-versus-facility difference. It is paid only under the CLFS.
Should this code be used for another transplant immunosuppressant level?
No. Use 80180 for a mycophenolic acid assay; assays for tacrolimus, sirolimus, or everolimus measure different drugs and have separate codes.
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
Fee sheets · Coming soon
Put 80180 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist