CPT code 80220: Hydroxychloroquine assay, drug-specific measurement2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Laboratory testing that measures hydroxychloroquine, reported when this specific drug assay is performed and paid under Medicare’s national Clinical Laboratory Fee Schedule.
Medicare pays $18.64 for 80220 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
$18.64
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2022
- 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 80220 covers
Code 80220 identifies a laboratory assay measuring hydroxychloroquine. Laboratories report this drug-specific code when hydroxychloroquine is the analyte measured. It distinguishes this service from assays of other medications, including methotrexate (80204), vancomycin (80202), and topiramate (80201).
Medicare pays 80220 under the Clinical Laboratory Fee Schedule (CLFS), not the physician fee schedule. The 2026 national CLFS amount is $18.64, unchanged from 2022 through 2026. One amount applies in every state and locality, with no geographic adjustment or office-versus-facility difference. The test is excluded from the physician fee schedule by statute. Medicare recorded 5,118 office services and no facility services for this code in 2024; this site-of-service count does not alter the single national CLFS payment basis.
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 80220
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 80220. 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 80220 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80220 on the lab fee schedule since 2022
80220 · CLFS 2026 Q4 (current)
$18.64
Unchanged since Jan 1, 2022
20 quarterly CLFS releases on file, first CLFS 2022 Q1. A code missing from a quarter wasn’t on that release.
80220 compared with similar tests
- 80299Drug assayUnlisted therapeutic drug$18.64
- 80220 identifies measurement of hydroxychloroquine. Code 80299 identifies a general quantitative drug assay.
- 80204Methotrexate assayDrug concentration$38.57
- Code 80204 identifies a methotrexate assay; use 80220 when the assay measures hydroxychloroquine.
- 80202Vancomycin levelAntibiotic concentration$13.54
- Code 80202 identifies a vancomycin assay; it is not the code for hydroxychloroquine measurement.
80220 billing questions
What does 80220 identify?
It identifies a laboratory assay measuring hydroxychloroquine.
When should 80220 be used instead of 80299?
Use 80220 when the assay measures hydroxychloroquine. Code 80299 identifies a general quantitative drug assay.
How does 80220 differ from 80204 and 80202?
Those codes identify assays for methotrexate and vancomycin, respectively. Code 80220 identifies the hydroxychloroquine assay.
How does Medicare pay for 80220?
Medicare pays it through the CLFS using one national amount across localities and office or facility settings. The test is excluded from the physician fee schedule.
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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