CPT code 80192: Procainamide level, with metabolites2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures procainamide together with its metabolites for therapeutic drug monitoring in patients receiving procainamide therapy.
Medicare pays $16.75 for 80192 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
$16.75
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 80192 covers
This laboratory assay measures procainamide and its metabolites, including N-acetylprocainamide, as part of therapeutic drug monitoring. It is used when clinicians managing a patient receiving procainamide need a level that includes the parent drug and metabolite results. Clinical laboratories perform the testing for hospitals and outpatient practices; the result supports the treating clinician’s assessment of drug exposure and therapy.
Report 80192 when the procainamide assay includes metabolites; report 80190 for an assay limited to procainamide. Medicare pays the test under the Clinical Laboratory Fee Schedule (CLFS), not the physician fee schedule. The 2026 national CLFS amount is $16.75, unchanged from 2020 through 2026. That amount applies in every state and locality, 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 80192
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 80192. 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 80192 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80192 on the lab fee schedule since 2020
80192 · CLFS 2026 Q4 (current)
$16.75
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.
80192 compared with similar tests
- 80190Procainamide levelParent drug$60.00
- 80192 includes procainamide metabolites in the assay. Select 80190 for an assay limited to procainamide.
- 80181Flecainide assay$18.64
- 80181 assays flecainide rather than procainamide. Select based on the drug being monitored.
- 80194Quinidine levelTherapeutic drug assay$14.60
- 80194 assays quinidine rather than procainamide. Select based on the drug being monitored.
80192 billing questions
When should 80192 be selected instead of 80190?
Select 80192 when the assay includes procainamide metabolites, such as N-acetylprocainamide. Select 80190 for an assay limited to procainamide.
Does including metabolites require additional units?
No. The assay includes procainamide and its metabolites; do not report separate units for each analyte.
Does Medicare pay 80192 under the CLFS?
Yes. Medicare pays 80192 under the CLFS at one national amount that applies in every state and locality, with no office-versus-facility difference.
What does the 80192 result include?
The assay measures procainamide together with its metabolites, including N-acetylprocainamide.
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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