CPT code 80202: Vancomycin level, antibiotic concentration2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This laboratory assay measures vancomycin concentration and is reported when clinicians need drug-level information during vancomycin treatment.
Medicare pays $13.54 for 80202 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
$13.54
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 80202 covers
Vancomycin concentration testing measures the antibiotic in a patient sample. Clinicians may order it during vancomycin therapy to assess drug exposure and inform dosing decisions. Hospital and independent clinical laboratories perform or report the assay for patients treated in inpatient and outpatient settings. The result is a measured drug level, not a record of the dose administered or a dosing service.
Report 80202 for the vancomycin assay. Medicare pays the test only through the CLFS at one national amount, with the same payment across states and localities and no office-versus-facility difference. The 2026 national CLFS amount is $13.54, unchanged since 2020. The code is excluded from the physician fee schedule by statute.
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 80202
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 80202. 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 80202 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80202 on the lab fee schedule since 2020
80202 · CLFS 2026 Q4 (current)
$13.54
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.
80202 compared with similar tests
- 80200Tobramycin levelAntibiotic monitoring$16.13
- Code 80200 identifies a tobramycin assay; 80202 identifies a vancomycin assay. Select the code matching the drug assayed.
- 80204Methotrexate assayDrug concentration$38.57
- Code 80204 identifies a methotrexate assay, while 80202 identifies a vancomycin assay. The measured drug distinguishes the codes.
- 80299Drug assayUnlisted therapeutic drug$18.64
- 80299 is described as a quantitative drug assay, while 80202 specifically identifies vancomycin.
80202 billing questions
When should 80202 be used instead of 80200?
Use 80202 for an assay measuring vancomycin. Code 80200 identifies an assay measuring tobramycin.
Does 80202 report a dose or a drug level?
It identifies a laboratory assay measuring vancomycin concentration, not the amount administered or a dosing service.
Which Medicare payment schedule applies to 80202?
Medicare pays 80202 through the CLFS. The code is excluded from the physician fee schedule by statute.
Does Medicare pay different amounts by locality or setting?
No. One national CLFS amount applies across localities, with no office or facility payment difference.
How does 80202 differ from 80299?
80202 specifically identifies vancomycin; 80299 is described as a quantitative drug assay.
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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