CPT code 80230: Infliximab assay, drug measurement2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures infliximab in a patient sample for therapeutic drug monitoring when clinicians assess drug exposure during biologic treatment.
Medicare pays $38.57 for 80230 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
$38.57
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 80230 covers
Code 80230 identifies laboratory measurement of infliximab in a patient sample. Clinicians use infliximab levels in therapeutic drug monitoring, including assessment of drug exposure when a patient has an inadequate or waning response. A level may be timed near an infusion when a trough is being evaluated. The assay measures the drug; testing for anti-infliximab antibodies concerns a separate analyte.
Report 80230 for the infliximab measurement; it does not represent an antibody assay. Medicare pays the test only under the CLFS at one national amount, with no geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $38.57, unchanged since 2020. The physician fee schedule excludes the test, and 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 80230
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 80230. 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 80230 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80230 on the lab fee schedule since 2020
80230 · CLFS 2026 Q4 (current)
$38.57
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.
80230 compared with similar tests
- 80280Vedolizumab assayDrug-specific measurement$38.57
- 80230 identifies infliximab measurement, while 80280 identifies vedolizumab measurement. The drug tested determines the code.
- 80204Methotrexate assayDrug concentration$38.57
- 80204 identifies a methotrexate assay; it is not the code for measuring infliximab.
- 80299Drug assayUnlisted therapeutic drug$18.64
- 80230 specifically identifies infliximab measurement. 80299 describes a quantitative drug assay without identifying infliximab.
80230 billing questions
Does 80230 measure infliximab or antibodies to infliximab?
It identifies measurement of infliximab. Testing for anti-infliximab antibodies concerns a separate analyte.
When might a clinician order an infliximab assay?
Clinicians may use it to assess drug exposure during treatment, including when a patient has an inadequate or waning response. A level may be timed near an infusion when a trough is being evaluated.
How does 80230 differ from 80280?
80230 identifies infliximab measurement; 80280 identifies vedolizumab measurement. Select the code for the drug tested.
Is 80230 paid under the physician fee schedule?
No. Medicare pays the test through the CLFS at one national amount, without geographic or office-versus-facility adjustment.
Should 80230 be used for a quantitative assay of another drug?
No. 80230 identifies measurement of infliximab. Use a code that identifies the different drug assay performed.
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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