CPT 80061: Lipid Panel (Cholesterol and Triglycerides)
Commercial payers pay $37 on average nationally for this procedure.
CPT code 80061 represents a lipid panel laboratory test in which a lab analyst measures blood levels of cholesterol and triglycerides to assess lipid status; the service is a clinical laboratory test typically performed on a blood specimen collected in an outpatient laboratory, hospital lab, or physician office-based lab setting.
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 reimbursement for CPT 80061 centers on BUCA’s average commercial rate of $36.90, with notable variation among major carriers. Blue Cross Blue Shield posts the highest dispersion and top-end rates (P75 $60.40, P25 $40.30), while Aetna and Cigna sit in the mid range of means ($22.10 and $16.00 respectively). UnitedHealth Group shows lower central tendency (median $8.00) and a relatively compressed middle distribution compared with Blue Cross Blue Shield.
Measuring interquartile spread (P75 minus P25) highlights where rates cluster: Blue Cross Blue Shield’s spread is $20.10, BUCA’s spread is $17.50, Cigna’s spread is $11.80, Aetna’s spread is $16.40, and UnitedHealth Group’s spread is $7.40. UnitedHealth Group is the tightest payer by that measure, while Blue Cross Blue Shield is the widest, signaling the greatest variability in negotiated commercial payments.