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Describe a service in plain words, or type a CPT/HCPCS code.

Effective Jan 1, 2024 through Mar 8, 2024. This is revision 1—CMS published revision 2 with rates effective Mar 9, 2024 (posted Apr 1, 2024).

CPT 80053

Full Metabolic Blood Panel

Priced under CLFS

80053 · PFS Q1 2024 · Historical

Status X is not separately payable under the PFS.

View applicable payment rules

Not at a published national rate. CPT 80053 carries status X (statutory exclusion) in the Q1 2024 release. The statutory definition of physician services does not include this item. Treat the blank amount as unpriced, not as $0.

PFS status evidence

Inspect PFS status evidence
Code
80053
Release
Q1 2024, revision 1
Result
Priced under CLFS

Citations

  • Establishes the PFS status (X) and the resulting pathway for this code: priced under clfs.

    Physician relative value file (PPRRVU)

    Q1 2024 · revision 1

    Superseded revision

    Release period: January 1 – March 8, 2024

    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 PPRRVU24_JAN.csv in rvu24a-updated-04-01-2024.zip (row 14,980)
    hcpcs (col 1)
    80053
    modifier (col 2)
    blank
    status_code (col 4)
    X

    SHA-256: 034f3aa88a63e6f7ca3859c09b3945dce139171a6fc5a710300fc7b815e9b65b

    Original source file

Compact facts

Why is there no national PFS amount for 80053?

Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. Status X is not separately payable under the PFS.

About this code

One blood test measuring a standard group of substances: blood sugar, salts and minerals, and markers of kidney and liver function. It gives a broad check on several organ systems at once. Medicare reported 27.2 million services under this code in CY2024.

Plain-language context only—not the official CPT descriptor and not coding guidance

Payment considerations Copy link

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

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, NCCI same-day edits: Not determined, MUE behavior: Not determined, Contractor pricing: Does not apply.

Payment review for 80053 Copy link

Laboratory panels, their component tests, and specimen collection can be paid under different rules and schedules. Compare like with like and keep a panel line separate from the draw that supplied the specimen.

What to reconcile

  • Use the CLFS amount for the laboratory service rather than treating a blank PFS amount as zero.
  • Check component bundling and repeat-test facts against the NCCI release effective for the date of service.
  • Keep 36415 as a distinct collection line and do not multiply it by the number of analytes in the panel.

Nearby payment lines

National Q1 2024 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.

Code Why compare Office Facility
80048 Nearby metabolic panel
80050 Broader panel line
36415 Separate specimen collection

Sources: CMS Clinical Laboratory Fee Schedule; CMS Medicare NCCI Policy Manual (2026); CMS Medicare Claims Processing Manual (Pub. 100-04).

Payment rules

Global period: what 80053'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 80053.

See every current NCCI pair for 80053 →

Common payment questions Copy link

Why would a Medicare claim for 80053 be denied or paid less?

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

  • Its status indicator is X (statutory exclusion)—The statutory definition of physician services does not include this item. See status indicators

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 80053 across quarterly releases.

Release Status Non-facility Facility
Q4 2026 takes effect Oct 1, 2026 X
Q3 2026 Jul 1, 2026 – Sep 30, 2026 X
Q2 2026 Apr 1, 2026 – Jun 30, 2026 X
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

How often 80053 is billed Copy link

Across Original Medicare in CY2024, 80053 ranked #5 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 2.1 times on average that year.

Beneficiaries
13.1M
Office + facility patients combined
Services
27.2M
Times it was billed
Allowed
$281.2M
Total Medicare allowed dollars
Compare: ↑ #4 more popular · 99233 ↓ #6 less popular · 99232

2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q1 2024 fee schedule above.

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q1 2024 release (effective January 2024). 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.

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 80053 National PFS baseline: No national PFS rate (Q1 2024; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/80053/2024/A/1