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CPT 80061: Lipid Panel — Cholesterol and Triglyceride Measurement
CPT code 80061 denotes a standard lipid panel that measures cholesterol fractions and triglycerides. This laboratory diagnostic test is a routine component of cardiovascular risk assessment and preventive care, widely ordered in outpatient and clinical laboratory settings. Nationally, lipid panels influence population screening programs, chronic disease management, and quality-measure reporting for cardiovascular risk reduction.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what 80061 represents clinically, the typical service setting, and the relationships between the lipid panel and related laboratory tests. The publication outlines common billing considerations, relevant diagnostic contexts such as hyperlipidemia and screening for lipoid disorders, and how 80061 aligns with related laboratory codes used in lipid management workflows.
This summary provides benchmarks and operational context relevant to billing and coding teams, laboratory managers, and clinicians who order lipid testing. It highlights where 80061 sits within routine preventive care and chronic disease monitoring, and it identifies companion tests often billed in the same encounter. Data not available in the input.
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Billing Code Overview
CPT code 80061 is a lipid panel performed by a laboratory analyst to measure blood cholesterol fractions and triglycerides. The test quantifies total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol (direct or calculated), and triglyceride levels to assess lipid status.
Service Type: Laboratory diagnostic test
Typical Site of Service: Clinical laboratory or outpatient phlebotomy site
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.