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CPT 80050 Medicare payment status

Excluded from PFS

80050 · PFS Q4 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

CMS RVU26DOctober 1 – December 31, 2026revision 2

PFS status evidence

Physician relative value file (Q4 2026) · rvu26d-updated-08-26-2026.zip (PPRRVU2026_Oct_nonQPP.csv row 9,587)
Inspect PFS status evidence
Code
80050
Release
Q4 2026, revision 2
Result
Excluded from PFS

Citations

  • Shows this code’s PFS status (N). Result: Excluded from PFS.

    Physician relative value file (PPRRVU)CMS RVU26DOctober 1 – December 31, 2026revision 2

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

    PPRRVU2026_Oct_nonQPP.csv row 9,587 in rvu26d-updated-08-26-2026.zip

    In the CMS file

    Loading rows 9,585–9,589 of PPRRVU2026_Oct_nonQPP.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

Plain-text summaryReport a problem

CPT 80050 has no published national rate. It carries status N (non-covered) in the Q4 2026 release. Medicare covers no part of this service. The blank amount means unpriced, not $0.

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.

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 Q4 2026 Physician Fee Schedule release this page shows. Each code above was checked against that release before being shown here.

Payment considerations Copy link

Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.

NCCI same-day edits Applies MUE behavior Applies
Other payment indicators (8)
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, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.
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
  • More than 0 units per patient per date of service exceeds 80050's Medically Unlikely Edit (MUE) limit. 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.

Which billing rules and modifiers apply? Copy link

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

Check a pair of codes 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 for the pair.

See every current NCCI pair for 80050 →

Billing together (NCCI edits) Copy link

NCCI Q4 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 →

Medically Unlikely Edit (MUE) limit: 0 units per patient per date of service.

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 80050 across quarterly releases.

Release Status Office Facility
Q4 2026 Oct 1, 2026 – present 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 and related codes Copy link

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q4 2026 release (effective October 2026). National baselines use GPCI 1.000 and exclude sequestration. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.

Physician relative value file (Q4 2026) · rvu26d-updated-08-26-2026.zip (PPRRVU2026_Oct_nonQPP.csv row 9,587)

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

CPT 80050 National PFS baseline: No national PFS rate (Q4 2026; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU26D, PPRRVU2026_Oct_nonQPP.csv row 9,587. Localis. https://localishealth.com/cpt/80050/2026/D