CPT code 80201: Topiramate level, topiramate-specific assay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This laboratory assay measures topiramate and is reported for testing of this specific medication analyte rather than another drug.
Medicare pays $11.92 for 80201 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
$11.92
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 80201 covers
80201 identifies the clinical laboratory assay for topiramate. It is the analyte-specific code for testing topiramate, not a code for a general quantitative drug assay or for testing another medication. Nearby drug-assay codes identify different analytes, including zonisamide (80203), rufinamide (80210), and lacosamide (80235). The reported code should match the drug measured by the assay. This distinction separates the topiramate test from assays whose codes identify other medications.
Medicare pays 80201 only through the CLFS. The 2026 national CLFS amount is $11.92 and has remained unchanged since 2020. The same amount applies in every state and locality, without geographic or office/facility adjustment. The physician fee schedule does not pay this test.
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 80201
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 80201. 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 80201 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80201 on the lab fee schedule since 2020
80201 · CLFS 2026 Q4 (current)
$11.92
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.
80201 compared with similar tests
- 80203Zonisamide levelQuantitative drug assay$13.25
- 80203 identifies a zonisamide assay. Select 80201 when the measured drug is topiramate.
- 80235Lacosamide assayDrug measurement$27.11
- 80235 identifies a lacosamide assay; 80201 identifies a topiramate assay.
- 80299Drug assayUnlisted therapeutic drug$18.64
- 80299 describes a quantitative drug assay without naming topiramate. 80201 identifies the topiramate assay.
80201 billing questions
What does 80201 identify?
It identifies a clinical laboratory assay for topiramate. It is specific to that analyte, not a general quantitative drug assay.
Is 80201 the code for a zonisamide assay?
No. 80201 identifies topiramate testing; 80203 identifies a zonisamide assay.
Does Medicare pay 80201 under the physician fee schedule?
No. Medicare pays this test through the CLFS, with the same national amount across localities and office or facility settings.
How does 80201 differ from 80299?
80201 identifies a topiramate assay. 80299 describes a quantitative drug assay without naming topiramate.
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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