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    v1.0.30
    OpenPayerBilling CodesOrgan or Disease Oriented PanelsCPT cpt-80069-renal-function-panel-lab-test
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    CPT 80069: Renal Function Panel, Blood

    Commercial payers pay $38 on average nationally for this procedure.

    CPT code 80069 describes a renal function panel laboratory service in which a lab analyst measures blood levels of specific chemicals (such as electrolytes, creatinine, and blood urea nitrogen) to evaluate kidney function; the service is a clinical laboratory test typically performed in a clinical laboratory or hospital laboratory setting and ordered to assess renal status or monitor known kidney disease.

    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

    Commercial rates for CPT 80069 cluster around BUCA’s average commercial benchmark of $37.9, with notable divergence among major carriers. Blue Cross Blue Shield’s distribution centers higher while UnitedHealth Group and Cigna occupy lower parts of the spectrum; Aetna shows an extreme high outlier. This positions BUCA as a mid-market reference point relative to these payers.

    Dispersion (P75 minus P25) highlights variability: Aetna’s range is $7.0 (P75 $13.9 minus P25 $6.0), Blue Cross Blue Shield’s range is $25.0 (P75 $58.4 minus P25 $31.0), BUCA’s range is $19.6 (P75 $38.4 minus P25 $19.8), Cigna’s range is $7.0 (P75 $12.3 minus P25 $5.0), and UnitedHealth Group’s range is $5.1 (P75 $8.7 minus P25 $3.8). UnitedHealth Group is the tightest, Blue Cross Blue Shield the widest.

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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 with a history of hypertension and type 2 diabetes presents to a primary care clinic for routine monitoring. The clinician orders a renal function panel to evaluate kidney performance after prior laboratory abnormalities and ongoing chronic kidney disease management. The patient has a phlebotomy draw performed at the clinic's lab; serum is sent to the clinical medical laboratory for analysis. The lab analyst measures blood levels of creatinine, blood urea nitrogen, electrolytes (including potassium), and related chemistries to calculate estimated glomerular filtration rate (eGFR) and assess for proteinuria or acute changes. Results are routed to the ordering provider—often a family medicine or internal medicine physician—for interpretation, medication adjustment, and documentation in the outpatient chart. Typical workflow steps: specimen collection, specimen labeling and transport to the clinical lab, analytic testing of renal panel analytes, result verification by the lab, and reporting to the ordering clinician for follow-up or further diagnostic testing (for example, repeat tests, urine studies, or nephrology referral).

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    80053Comprehensive metabolic panelBroader chemistry panel that includes renal function tests; may be ordered instead of or in addition to a dedicated renal panel

    Related Modifiers

    8 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…
    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…
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    291U00000X
    207Q00000X
    207R00000X
    3104A0630X
    282N00000X
    111NS0005X
    101Y00000X
    261QR0200X

    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-80048-BASIC-METABOLIC-PANEL-BMP

    CPT 80048: 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-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.

    82565
    Creatinine; blood
    Individual analyte often included in a renal function panel or ordered separately to assess kidney function
    84520Urea nitrogen; quantitativeMeasurement of blood urea nitrogen (BUN), a core component of renal function assessment
    84132Potassium; serum, plasma or whole bloodElectrolyte measured in renal panels; important for detecting renal-related electrolyte disturbances
    82310Calcium; totalElectrolyte/chemistry sometimes included when evaluating overall metabolic status in renal disease