CPT code 80210: Rufinamide assay, drug-specific measurement2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Rufinamide assay measures this antiseizure medication in a patient specimen and identifies the drug-specific laboratory test when that medication is measured.
Medicare pays $27.11 for 80210 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
$27.11
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2021
- 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 80210 covers
Code 80210 identifies a laboratory measurement of rufinamide, an antiseizure medication. It is the drug-specific assay rather than a general quantitative drug assay. A laboratory reports it when the test performed measures rufinamide; an assay measuring a different medication is identified by that drug’s code. The service concerns measurement of the medication, not a dose or tablet count.
Medicare pays code 80210 through the CLFS only. CMS sets one national amount applying in every state and locality, with no geographic adjustment and no office-versus-facility difference. The 2026 national CLFS amount is $27.11, unchanged from 2021 through 2026. The physician fee schedule excludes the test by statute, so Medicare payment is through the CLFS.
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 80210
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 80210. 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 80210 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80210 on the lab fee schedule since 2021
80210 · CLFS 2026 Q4 (current)
$27.11
Unchanged since Jan 1, 2021
24 quarterly CLFS releases on file, first CLFS 2021 Q1. A code missing from a quarter wasn’t on that release.
80210 compared with similar tests
- 80201Topiramate levelTopiramate-specific assay$11.92
- Use 80201 for measurement of topiramate and 80210 for measurement of rufinamide.
- 80203Zonisamide levelQuantitative drug assay$13.25
- 80203 identifies quantitative measurement of zonisamide; 80210 identifies measurement of rufinamide.
- 80235Lacosamide assayDrug measurement$27.11
- Use 80235 for measurement of lacosamide and 80210 for measurement of rufinamide.
- 80299Drug assayUnlisted therapeutic drug$18.64
- 80299 is the general quantitative drug-assay code; 80210 specifically identifies measurement of rufinamide.
80210 billing questions
When should 80210 be used instead of 80299?
Use 80210 when the laboratory measures rufinamide. Code 80299 is the general quantitative drug-assay code.
Is 80210 a drug screen or a rufinamide assay?
It identifies measurement of rufinamide specifically, rather than a broad screen for multiple medications.
How should the service be counted?
Report 80210 for the rufinamide measurement; it identifies the assay, not the patient's dose or number of tablets.
Can modifier 26 be reported for a physician interpretation?
Medicare pays 80210 through the CLFS only; the physician fee schedule excludes the test by statute.
How does Medicare pay for 80210?
Medicare pays one national CLFS amount across states and localities, with no office-versus-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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