CPT 80074: Medicare rates for 2026
80074: Acute hepatitis panel (Lab). Description is our plain-language summary.
Which number to compare to
Match the reference to the kind of charge. A hospital visit often produces two bills: the hospital's facility charge and the doctor's professional charge.
| Kind of charge | 2026 national amount | Notes |
|---|---|---|
| Lab test (lab fee schedule) | $47.63 | National limit amount; local amounts can be lower. Source: CMS Clinical Laboratory Fee Schedule 2026 Q4, national limit. |
| Hospital outpatient facility charge | no separate rate | Status Q4: Conditionally packaged lab test: no separate OPPS payment when billed with other hospital outpatient services; paid under the lab fee schedule when it is the only service. Source: CMS OPPS Addendum B, October 2026, national unadjusted. |
- All amounts are CY2026 national unadjusted rates (PFS RVU26D October release, conversion factor $33.4009; CLFS 2026 Q4; OPPS Addendum B October 2026). Medicare adjusts them by area, so local amounts differ.
- Rates are per unit. If your line shows more than one unit, multiply.
- Modifiers change the reference: -26 and -TC split imaging/tests; repeat modifiers (76, 77, 91) and distinct-service modifiers (59, XE, XS, XP, XU) mean a repeated line can be legitimate.
- Under hospital outpatient rules this code can be packaged: when it's billed with certain other services the same day, Medicare makes no separate payment for it. A hospital may still list a charge for it.
What a higher price means
Hospital and doctor list prices are often several times Medicare. That's usually legal, and it isn't proof of a billing error. What you actually owe depends on your insurance, your plan's negotiated rate, or the provider's self-pay price.
Useful next steps if your charge for 80074 looks high:
- If you're insured, compare the bill with your insurer's Explanation of Benefits (EOB). An in-network provider generally can't bill more than the EOB's patient amount.
- Ask for an itemized bill with codes, dates, units and modifiers (free letter).
- If you're uninsured or self-pay, ask for the self-pay price and the hospital's financial assistance policy. If you got a Good Faith Estimate and the bill is $400+ higher, you may be able to use the No Surprises Act dispute process.
Last checked against CMS files October 14, 2026. Not legal, medical, or financial advice.
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