CPT code 80280: Vedolizumab assay, drug-specific measurement2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This laboratory assay measures vedolizumab and is reported for testing of that drug rather than another therapeutic drug.
Medicare pays $38.57 for 80280 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 8 sections
What 80280 covers
Code 80280 identifies a laboratory assay that measures vedolizumab. It is specific to that drug; infliximab and voriconazole are measured under separate drug-assay codes, 80230 and 80285. Laboratories report 80280 when the test performed measures vedolizumab. The code identifies the drug being measured, rather than an infusion service or a general quantitative drug assay. Code 80299 is a separate quantitative drug-assay code, while 80280 names vedolizumab specifically.
Medicare pays 80280 under the CLFS. One national amount applies in every state and locality, without geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $38.57 and has remained unchanged since 2020. Medicare pays this test through the CLFS rather than the physician fee schedule.
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 80280
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 80280. 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 80280 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80280 on the lab fee schedule since 2020
80280 · 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.
80280 compared with similar tests
- 80230Infliximab assayDrug measurement$38.57
- 80230 measures infliximab; 80280 measures vedolizumab. Choose according to the drug tested.
- 80299Drug assayUnlisted therapeutic drug$18.64
- 80299 is a quantitative drug-assay code; 80280 specifically identifies vedolizumab measurement.
- 80285Voriconazole assayDrug concentration$27.11
- 80285 measures voriconazole; 80280 measures vedolizumab.
80280 billing questions
When should 80280 be chosen instead of 80230?
Use 80280 for vedolizumab and 80230 for infliximab. Select the code for the drug measured.
How does 80280 differ from 80285?
80280 identifies measurement of vedolizumab; 80285 identifies measurement of voriconazole.
How does 80280 differ from 80299?
80280 specifically identifies vedolizumab measurement. 80299 is a quantitative drug-assay code.
Does Medicare pay 80280 under the physician fee schedule?
No. Medicare pays 80280 through the CLFS, with one national amount across localities and settings.
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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