CPT code 80235: Lacosamide assay, drug measurement2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Laboratory measurement of lacosamide is reported when this specific drug is the analyte; Medicare pays the test through the national CLFS.
Medicare pays $27.11 for 80235 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 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 80235 covers
80235 identifies laboratory measurement of lacosamide, an antiseizure medication. It is specific to this analyte, distinguishing lacosamide testing from assays for other named drugs such as topiramate, zonisamide, and rufinamide, and from a general quantitative drug assay. Report this code when the laboratory service measures lacosamide. The selected code follows the drug measured, not a shared therapeutic category.
Medicare pays 80235 through the Clinical Laboratory Fee Schedule (CLFS) only. The 2026 national CLFS amount is $27.11 and has remained unchanged since 2020. One amount applies in every state and locality, with no geographic adjustment or office-versus-facility difference. The physician fee schedule does not pay the 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 80235
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 80235. 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 80235 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80235 on the lab fee schedule since 2020
80235 · CLFS 2026 Q4 (current)
$27.11
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.
80235 compared with similar tests
- 80201Topiramate levelTopiramate-specific assay$11.92
- 80201 identifies topiramate measurement; 80235 identifies lacosamide measurement.
- 80203Zonisamide levelQuantitative drug assay$13.25
- 80203 identifies zonisamide measurement; 80235 identifies lacosamide measurement.
- 80210Rufinamide assayDrug-specific measurement$27.11
- 80210 identifies rufinamide measurement; 80235 identifies lacosamide measurement.
- 80299Drug assayUnlisted therapeutic drug$18.64
- 80299 describes a quantitative drug assay more generally, while 80235 specifically identifies lacosamide measurement.
80235 billing questions
Which analyte does 80235 identify?
It identifies laboratory measurement of lacosamide.
How does 80235 differ from 80201, 80203, and 80210?
Those codes identify assays for topiramate, zonisamide, and rufinamide, respectively. Select the code for the drug measured.
How does 80235 differ from 80299?
80235 identifies lacosamide measurement; 80299 describes a quantitative drug assay more generally.
Does Medicare pay 80235 under the physician fee schedule?
No. Medicare pays this test through the CLFS only.
Does the CLFS amount vary by locality or setting?
No. One national amount applies in every state and locality, without an 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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