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CPT 80050

Excluded from PFS

80050 · PFS Q3 2026

Status N: non-covered. Medicare covers no part of this service, so the PFS produces no payment amount.

View applicable payment rules
View CMS source and method

Not at a published national rate. CPT 80050 carries status N (non-covered) in the Q3 2026 release. Medicare covers no part of this service. Treat the blank amount as unpriced, not as $0.

PFS status evidence

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 9,527)
Inspect PFS status evidence
Code
80050
Release
Q3 2026, revision 1
Result
Excluded from PFS

Citations

  • Establishes the PFS status (N) and the resulting pathway for this code: excluded from pfs.

    Physician relative value file (PPRRVU)

    Q3 2026 · revision 1

    Latest revision of this release

    Release period: July 1 – September 30, 2026

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    Record details PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 9,527)
    hcpcs (col 1)
    80050
    modifier (col 2)
    blank
    status_code (col 4)
    N

    SHA-256: b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

    Original source file

Compact facts

Why is there no national PFS amount for 80050?

Its status indicator is N (non-covered). Medicare covers no part of this service. Status N: non-covered. Medicare covers no part of this service, so the PFS produces no payment amount.

Payment considerations Copy link

Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.

NCCI same-day edits Applies
Other payment indicators (9)

Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.

What Medicare pays for instead of 80050 Copy link

The tests that make up the panel are each covered and priced on the lab fee schedule, so they are billed as separate lines rather than as one panel code.

Code When it applies Medicare amount
80053 The comprehensive metabolic panel component. $10.56
85025 The blood count component, with an automated differential. A count billed with a manual differential uses a different code pair and prices slightly lower. $7.77
84443 The thyroid-stimulating hormone component. $16.80
Billed together $35.13

Medicare does not pay for the panel as a single code. CMS addressed this code by name when it set the CY2018 lab fee schedule, saying it is not payable under Medicare and had never been listed on the Clinical Laboratory Fee Schedule at all. The widely repeated story that CMS removed it for overuse is not what CMS said.

Being non-covered is not the same as being bundled: there is no Medicare payment for 80050 to fold into another service. What that means for billing the patient depends on why the code is not covered—services excluded by statute are treated differently from services ruled out by a coverage determination—and the status letter alone does not record which applies. How status indicators work covers the distinction.

Amounts from the current CMS Clinical Laboratory Fee Schedule, which versions independently of the Q3 2026 Physician Fee Schedule release this page shows. Each code above was checked against that release before being shown here.

Payment rules

Global period: what 80050's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Can you bill it with another code? Copy link

Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit between it and 80050.

See every current NCCI pair for 80050 →

Billing together (NCCI edits) Copy link

NCCI Q3 2026

Based on CMS's National Correct Coding Initiative (NCCI). A few examples appear here; use the complete edit page to check a specific pair.

Not separately payable with 80050 on the same date of service—no modifier bypasses the edit (modifier indicator 0)

0002M 80050 denies
0003M 80050 denies
0166U 80050 denies

Showing 3 of 5.

Check a paired code or view all 5 NCCI pairs →

Common payment questions Copy link

Why would a Medicare claim for 80050 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

  • Its status indicator is N (non-covered)—Medicare covers no part of this service. See status indicators
  • 5 codes form NCCI pairs with 80050 carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

History

Rate history by release Copy link

National non-facility amount for 80050 across quarterly releases.

Release Status Non-facility Facility
Q4 2026 takes effect Oct 1, 2026 N — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 N — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 N — —
When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Usage & related

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q3 2026 release (effective July 2026). National baselines use GPCI 1.000 and exclude sequestration. Status and payment instructions determine whether a national amount is established; blank RVUs stay blank. Releases are immutable: historical evidence remains tied to the specified release. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 9,527)

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

This citation identifies the source release, so its evidence remains reproducible after a newer release lands.

CPT 80050 National PFS baseline: No national PFS rate (Q3 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/80050/2026/C