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    v1.0.30
    OpenPayerBilling CodesOrgan or Disease Oriented PanelsCPT cpt-80048-basic-metabolic-panel-bmp
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    CPT 80048: Basic Metabolic Panel (BMP)

    Commercial payers pay $35 on average nationally for this procedure.

    CPT code 80048 describes a basic metabolic panel (BMP) laboratory test measuring eight serum chemistries — total calcium, sodium, potassium, chloride, carbon dioxide (bicarbonate), glucose, blood urea nitrogen (BUN), and creatinine — performed by a clinical laboratory inpatient or outpatient using automated chemistry analyzers; this service is a clinical laboratory chemistry panel commonly ordered to evaluate electrolyte balance, renal function, and metabolic status.

    For related coverage guidance, see recent payer policy updates: Long-Acting Injectable Antiretroviral Agents for HIV, B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays.

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    National Reimbursement Benchmarks

    National commercial pricing for CPT 80048 centers around the BUCA average commercial rate of $34.6, with notable variation among major payers. Blue Cross Blue Shield posts the highest dispersion, with a P75–P25 range of $27.0 ($66.0 minus $34.0), reflecting substantial spread in contracted rates; Aetna’s spread is $9.0 ($14.8 minus $6.0), Cigna’s spread is $6.6 ($11.7 minus $5.1), and UnitedHealth Group’s spread is $4.8 ($8.5 minus $3.7). These differences indicate that Blue Cross Blue Shield agreements are the most variable while UnitedHealth Group and Cigna provide comparatively tighter distributions around their medians.

    Looking at central tendencies, Blue Cross Blue Shield also shows a high mean of $52.9 and a median of $49.9, contrasting with UnitedHealth Group’s mean of $7.4 and median of $5.1. Aetna’s mean is $14.3 with a median of $8.5, and Cigna’s mean is $9.3 with a median of $8.3. Blue Cross Blue Shield’s combination of higher central values and the widest P75–P25 range suggests both higher average commercial payment levels and greater variability in contract pricing for this code compared with other national payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient presents to a primary care clinic for routine follow-up of chronic hypertension and stage 3 chronic kidney disease. The clinician orders a basic metabolic panel to evaluate electrolytes, renal function, and glucose control after the patient reports increased fatigue and a recent change in antihypertensive medication. Blood is drawn via venipuncture in the clinic laboratory and the specimen is processed by the clinical medical laboratory technologist. Results for sodium, potassium, chloride, bicarbonate (reported as CO2), blood urea nitrogen, creatinine, glucose, and total calcium are returned to the ordering Family Medicine physician. The clinician reviews the BMP to assess for hyponatremia, hyperkalemia, renal function trends, or medication-related electrolyte disturbances and documents interpretation in the outpatient chart. Typical sites of service include outpatient clinic laboratories, hospital outpatient phlebotomy stations, and independent clinical laboratories. Typical service type: routine clinical chemistry panel for monitoring electrolytes and renal/metabolic status.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    80047Basic metabolic panel (Calcium, ionized)Alternative BMP variant that measures ionized calcium instead of total calcium; may be ordered when ionized calcium is clinically indicated

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…
    99Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    291U00000X
    207Q00000X
    207R00000X
    246YC3301X
    3418M1120X
    2084N0402X
    284300000X
    208VP0014X

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    10 rows

    PolicyPayerEffective Date
    Long-Acting Injectable Antiretroviral Agents for HIVColorado Rocky Mountain Health Plans2026-10-01
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01

    Related Codes

    CPT-80047-BASIC-METABOLIC-PANEL-BMP

    CPT 80047: Basic Metabolic Panel (BMP)

    CPT-80050-GENERAL-HEALTH-PANEL-SCREENING-LAB

    CPT 80050: General Health Panel Screening

    CPT-80051-ELECTROLYTE-PANEL-NA-CL-K-CLO-CO2

    CPT 80051: Electrolyte Panel (Na, K, Cl, CO2)

    CPT-80053-COMPREHENSIVE-METABOLIC-PANEL-CMP

    CPT 80053: Comprehensive Metabolic Panel (CMP)

    CPT-80055-OBSTETRIC-PANEL-PRENATAL-LAB-TESTING

    CPT 80055: Obstetric Laboratory Panel

    CPT-80061-LIPID-PANEL-CHOLESTEROL-TRIGLYCERIDES

    CPT 80061: Lipid Panel (Cholesterol and Triglycerides)

    CPT-80069-RENAL-FUNCTION-PANEL-LAB-TEST

    CPT 80069: Renal Function Panel, Blood

    CPT-80074-ACUTE-HEPATITIS-PANEL-SEROLOGY

    CPT 80074: Acute Hepatitis Serology Panel

    CPT-80076-HEPATIC-FUNCTION-PANEL-LIVER-CHEMISTRY

    CPT 80076: Hepatic Function Panel (Liver Chemistry Tests)

    CPT-80081-OBSTETRIC-PANEL-INITIAL-PRENATAL-TESTING

    CPT 80081: Obstetric Screening Panel for Prenatal Care

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    80053
    Comprehensive metabolic panel
    Broader panel that includes BMP analytes plus hepatic function tests; used when liver chemistry assessment is also needed
    80069Renal function panelFocused panel on renal markers; used when more detailed renal monitoring is required alongside or instead of a BMP
    80076Hepatic function panelFocused liver panel; ordered in addition to BMP when hepatic evaluation is required