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CPT CODE
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MEDICARE FEE CAP
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TEST NAME (SELECTED PRODUCTS/MANUFACTURERS)
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82055QW
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$15.10
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Alcohol Saliva Test (STC Diagnostics, QED Diagnostics)
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82120QW
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$5.25
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Amines and pH (Advance Amines and pH test, Quidel, BV Blue, Sekisui Diagnostics)
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83986QW
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$5.00
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Amines and pH (Advance Amines and pH test, Quidel, BV Blue, Sekisui Diagnostics)
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85576QW
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$30.01
|
Aspirin resistance test (VerifyNow Accumetrics)
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|
87905QW
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$17.20
|
Bacterial Vaginosis (Sekisui Diagnostics)
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83518QW
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$11.85
|
Bladder Cancer Antigen (BTA Stat Test Bion Diagnostics)
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83880QW
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$47.43
|
BNP test (Triage Meter, Biosite Corp)
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|
87324
|
$16.88
|
C. difficille (Sekisui Diagnostics)
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|
Varies
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Varies
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Chemistry Tests: Albumin, Alkaline Phosphatase, Amylase, GGT, Total Bilirubin, Total Protein (Abaxis Piccollo)
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82465QW
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$6.08
|
Cholesterol (Chemtrak, J & J, Roche, Actimed Labs, Lifestream Technologies)
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82044QW
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$6.44
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Dipstick Albumin (Chemstrip Micral Roche Corp, Immunodip, DCL, Sekisui Diagnostics)
|
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81002
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$3.57
|
Dipstick/Tablet Urinalysis
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81002
|
$3.57
|
Dipstick Urinalysis
|
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82570QW
|
$7.23
|
Creatinine (Bayer Multistix Pro 11, 10LS, 7G)
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|
81003QW
82570QW
|
$3.14
$7.23
|
Dipstick Urine Analyzer (Clinitek 50 Bayer Corp.; Urisys Roche Corp.)+ Creatinine (Bayer Status Analyzer)
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80101QW
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$19.24
|
Drugs of Abuse tests
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82272
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$4.54
|
FOB, Diagnostic (Hemoccult Beckman Coulter, Seroccult Propper)
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82270
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$4.54
|
FOB, Screening
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G0394
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$4.54
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FOB, single test for colorectal neoplasm
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82274QW or G0328
|
$22.22
|
FOB, Immunoassay (InSure Enterix, FOB Alfa Scientific, Hemoccult ICT Beckman Coulter, Instant Technologies, Immunostics)
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83001QW
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$25.97
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FSH (Biotechnostics, Menocheck Pro FSH Menopause Test)
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82273QW
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$4.54
|
Gastric Occult Blood (Beckman Coulter)
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82962
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$3.27
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Glucose Meters
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82951QW
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$17.99
|
Glucose Tolerance Test, 3 Specimens
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|
82947QW
|
$5.48
|
Glucose (HemoCue Glucose 201 Analyzer)
|
|
83036QW
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$13.56
|
Hemoglobin A1c (Axis-Shield Afinion, Bayer DCA 2000)
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83037QW
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$21.06
|
Hemoglobin A1c, approved for home use (Cholestech, Metrika, BioRad, Provalis)
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85014QW
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$3.31
|
Hematocrit (StatSpin)
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85018QW
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$3.31
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Hemoglobin (Hemocue)
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86318QW
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$18.22
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H. pylori test whole blood (Quidel, BD, Accutest, Instant Technologies, Sekisui Diagnostics)
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87338QW
|
$20.10
|
H. pylori test, stool (Meridian Bioscience, Immunocard)
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86703QW
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$19.17
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HIV Rapid Test (OraSure)
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87804QW
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$16.88
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Influenza Rapid Test Kits (Quidel, Binax, Sekisui Diagnostics)
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83655QW
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$16.91
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LeadCare II Blood Lead Test System (ESA Biosciences, Chelmsford, MA)
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|
80061QW
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$18.72
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Lipid Panel (Cholestech, Abaxis, Cardiocheck) (Cholest, HDL, Triglycerides)
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84460QW
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$7.40
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ALT (SGPT)
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84450QW
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$7.40
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AST (SGOT)
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83721QW
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$13.33
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LDL (Polymer Technology; Cardiocheck PA)
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|
86618QW
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$23.80
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Lyme Disease Rapid Test Kit (Inverness)
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82043QW
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$8.09
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Microalbumin, Urine Quantitative (Hemocue)
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83518QW
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$11.85
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Microalbumin Immunoassay (ICON Beckman Coulter)
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86308QW
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$7.28
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Mononucleosis Test Kits (Quidel, Inverness, Sekisui Diagnostics)
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80101QW
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$19.24
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Nicotine Test (NicCheck, Dynagen)
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|
84830
|
$14.02
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Ovulation Test Kits (Instant Technologies)
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|
81025
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$8.90
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Pregnancy Test Kits Urine, Qualitative (Beckman Coulter, Sekisui Diagnostics, Quidel, Inverness)
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84703QW
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$10.49
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Pregnancy Test Urine Instrument (Clinitek Bayer Corp)
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85610QW
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$5.49
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Prothrombin Time (Protime ITC Corp, CoaguChek Roche, Hemosense)
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87807QW
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$16.76
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RSV Rapid Test Kit (Binax, Integrated Biotechnology)
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85651
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$4.96
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Sedimentation Rate, Non-Automated
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87880QW
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$16.88
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Strep Rapid Test Kits (Beckman Coulter, Sekisui Diagnostics, Quidel, BD, Inverness, Sekisui Diagnostics, etc.)
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87808QW
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$16.88
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Trichomonas Rapid Test Kit (Sekisui Diagnostics)
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84443QW
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$23.47
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TSH, qualitative (Thyrotech)
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81007QW
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$3.59
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Urinary Tract Infections (Uriscreen Diatech Diagnostics)
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