| CPT CODE |
MEDICARE FEE CAP |
TEST NAME (SELECTED PRODUCTS/MANUFACTURERS) |
| 82055QW | $15.10 | Alcohol Saliva Test (STC Diagnostics, QED Diagnostics) |
| 82120QW | $5.25 | Amines and pH (Advance Amines and pH test, Quidel, BV Blue, Genzyme) |
| 83986QW | $5.00 | Amines and pH (Advance Amines and pH test, Quidel, BV Blue, Genzyme) |
| 85576QW | $30.01 | Aspirin resistance test (VerifyNow Accumetrics) |
| 83518QW | $11.85 | Bladder Cancer Antigen (BTA Stat Test Bion Diagnostics) |
| 83880QW | $47.43 | BNP test (Triage Meter, Biosite Corp) |
| Varies | Varies | Chemistry Tests: Albumin, Alkaline Phosphatase, Amylase, GGT, Total Bilirubin, Total Protein (Abaxis Piccollo) |
| 82465QW | $6.08 | Cholesterol (Chemtrak, J & J, Roche, Actimed Labs, Lifestream Technologies) |
| 82044QW | $6.39 | Dipstick Albumin (Chemstrip Micral Roche Corp, Immunodip, DCL) |
| 81002 | $3.57 | Dipstick/Tablet Urinalysis |
| 81002 | $3.57 | Dipstick Urinalysis |
| 82570QW | $7.23 | Creatinine (Bayer Multistix Pro 11, 10LS, 7G) |
81003QW
82570QW
| $3.14
$7.23 | Dipstick Urine Analyzer (Clinitek 50 Bayer Corp.; Urisys Roche Corp.)+ Creatinine (Bayer Status Analyzer) |
| 80101QW | $19.24 | Drugs of Abuse tests |
| 82272 | $4.54 | FOB, Diagnostic (Hemoccult Beckman Coulter, Seroccult Propper) |
| 82270 | $4.54 | FOB, Screening |
| G0394 | $4.54 | FOB, single test for colorectal neoplasm |
| 82274QW or G0328 | $22.22 | FOB, Immunoassay (InSure Enterix, FOB Alfa Scientific, Hemoccult ICT Beckman Coulter, Instant Technologies, Immunostics) |
| 83001QW | $25.97 | FSH (Biotechnostics, Menocheck Pro FSH Menopause Test) |
| 82273QW | $4.54 | Gastric Occult Blood (Beckman Coulter) |
| 82962 | $3.27 | Glucose Meters |
| 82951QW | $17.99 | Glucose Tolerance Test, 3 Specimens |
| 82947QW | $5.48 | Glucose (HemoCue Glucose 201 Analyzer) |
| 83036QW | $13.56 | Hemoglobin A1c (Axis-Shield Afinion, Bayer DCA 2000) |
| 83037QW | $21.06 | Hemoglobin A1c, approved for home use (Cholestech, Metrika, BioRad, Provalis) |
| 85014QW | $3.31 | Hematocrit (StatSpin) |
| 85018QW | $3.31 | Hemoglobin (Hemocue) |
| 86318QW | $18.09 | H. pylori test whole blood (Quidel, BD, Accutest, Instant Technologies) |
| 87338QW | $20.10 | H. pylori test, stool (Meridian Bioscience, Immunocard) |
| 86703QW | $19.17 | HIV Rapid Test (OraSure) |
| 87804QW | $16.76 | Influenza Rapid Test Kits (Quidel, Binax) |
| 83655QW | $16.91 | LeadCare II Blood Lead Test System (ESA Biosciences, Chelmsford, MA) |
| 80061QW | $18.72 | Lipid Panel (Cholestech, Abaxis, Cardiocheck) (Cholest, HDL, Triglycerides) |
| 84460QW | $7.40 | ALT (SGPT) |
| 84450QW | $7.40 | AST (SGOT) |
| 83721QW | $13.33 | LDL (Polymer Technology; Cardiocheck PA) |
| 86618QW | $23.80 | Lyme Disease Rapid Test Kit (Inverness) |
| 82043QW | $8.09 | Microalbumin, Urine Quantitative (Hemocue) |
| 83518QW | $11.85 | Microalbumin Immunoassay (ICON Beckman Coulter) |
| 86308QW | $7.23 | Mononucleosis Test Kits (Quidel, Inverness, Genzyme) |
| 80101QW | $19.24 | Nicotine Test (NicCheck, Dynagen) |
| 84830 | $14.02 | Ovulation Test Kits (Instant Technologies) |
| 81025 | $8.84 | Pregnancy Test Kits Urine, Qualitative (Beckman Coulter, Genzyme, Quidel, Inverness) |
| 84703QW | $10.49 | Pregnancy Test Urine Instrument (Clinitek Bayer Corp) |
| 85610QW | $5.49 | Prothrombin Time (Protime ITC Corp, CoaguChek Roche, Hemosense) |
| 87807QW | $16.76 | RSV Rapid Test Kit (Binax, Integrated Biotechnology) |
| 85651 | $4.96 | Sedimentation Rate, Non-Automated |
| 87880QW | $16.76 | Strep Rapid Test Kits (Beckman Coulter, Genzyme, Quidel, BD, Inverness, etc.) |
| 87808QW | $16.76 | Trichomonas Rapid Test Kit (Genzyme) |
| 84443QW | $23.47 | TSH, qualitative (Thyrotech) |
| 81007QW | $3.59 | Urinary Tract Infections (Uriscreen Diatech Diagnostics) |
