CPT code 80190: Procainamide level, parent drug2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures procainamide during treatment with this antiarrhythmic medication to assess drug exposure or evaluate possible toxicity.
Medicare pays $60.00 for 80190 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
$60.00
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 80190 covers
This laboratory assay measures procainamide, an antiarrhythmic medication. Clinicians may order it during treatment to assess drug exposure or evaluate possible toxicity. Cardiologists and other treating clinicians use the result alongside the patient's dose, collection timing, clinical response, and other relevant findings. A clinical laboratory performs and reports the assay.
Report 80190 for measurement of procainamide itself. When N-acetylprocainamide is also measured, report the separate assay for that analyte. Medicare pays 80190 only through the CLFS, using one national amount across states and localities, with no office-versus-facility difference. The 2026 national CLFS amount is $60.00, unchanged from 2020 through 2026.
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 80190
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 80190. 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 80190 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80190 on the lab fee schedule since 2020
80190 · CLFS 2026 Q4 (current)
$60.00
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.
80190 compared with similar tests
- 80192Procainamide levelWith metabolites$16.75
- 80190 measures procainamide; 80192 measures its N-acetylated metabolite. Select the code for the analyte tested.
- 80194Quinidine levelTherapeutic drug assay$14.60
- 80194 measures quinidine, not procainamide. Select the assay for the medication whose concentration is being measured.
- 80181Flecainide assay$18.64
- 80181 measures flecainide. It is not interchangeable with the procainamide assay represented by 80190.
80190 billing questions
When should 80190 be reported instead of 80192?
Report 80190 for procainamide itself. Code 80192 is for the N-acetylprocainamide metabolite.
Can 80190 and 80192 be reported together?
Yes, when both procainamide and its N-acetyl metabolite are measured. Each code represents a different analyte.
Does 80190 include a physician interpretation?
80190 identifies the laboratory assay. Medicare pays the test through the CLFS.
How does Medicare pay for 80190?
Medicare pays one national CLFS amount across states and localities, with no office or facility 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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