Find policies, billing codes, payers, states, and providers

CPT 82465: Total Cholesterol Measurement in Serum or Whole Blood

CPT code 82465 identifies a laboratory assay that measures total cholesterol in serum or whole blood. Total cholesterol is a core biomarker used in cardiovascular risk assessment and population health screening, making this test widely used across clinical settings. Nationally, services billed under CPT code 82465 support preventive care, chronic disease management, and medication monitoring for lipid-lowering therapies.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for the test, typical sites of service, and payer coverage landscape. The publication summarizes billing considerations, common modifiers encountered in claims, and where CPT code 82465 fits within laboratory service lines.

This report provides benchmarks and policy-relevant points for stakeholders evaluating utilization and coverage of total cholesterol testing. It also outlines clinical scenarios in which measurement of total cholesterol is commonly ordered and highlights where to find related procedural coding. Data not available in the input will be indicated when applicable.

Customize your policy alerts

Sign up for cpt 82465 policy alerts

Get alerted when payer policies referencing 82465 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CPT code 82465 measures total cholesterol in a patient specimen of serum or whole blood. This is a laboratory quantitative assay that reports the concentration of total cholesterol as part of a lipid profile or standalone cardiovascular risk assessment.

Service Type: Clinical laboratory test — quantitative serum or whole blood analysis

Typical Site of Service: Clinical laboratory, hospital laboratory, outpatient laboratory draw site, or physician office laboratory

Data not available in the input.

Explore openpayer tools

View all tools

Find policies, billing codes, payers, states, and providers

CPT 82465: Total Cholesterol Measurement in Serum or Whole Blood

Customize your policy alerts

Sign up for cpt 82465 policy alerts

Get alerted when payer policies referencing 82465 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Service Type: Clinical laboratory test — quantitative serum or whole blood analysis

Typical Site of Service: Clinical laboratory, hospital laboratory, outpatient laboratory draw site, or physician office laboratory

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 54-year-old male patient presents to an outpatient primary care clinic for routine cardiovascular risk assessment. The clinician documents a history of hyperlipidemia and hypertension and orders fasting laboratory studies including a lipid panel. Nursing obtains a serum specimen via venipuncture and sends it to the facility laboratory. The medical laboratory analyst performs a quantitative enzymatic assay to measure the level of total cholesterol in the specimen and records the result in the laboratory information system. The result is reviewed by the ordering provider and incorporated into clinical decision-making for lipid-lowering therapy and risk stratification. Typical site of service is an outpatient laboratory or hospital laboratory performing routine clinical chemistry testing.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the professional interpretation component if applicable to lab services that have separate technical/professional components (rare for automated chemistry).
`90`	Reference (outside) laboratory	Use when the specimen is sent to an outside/reference laboratory for completion of the test.
`91`	Repeat clinical diagnostic laboratory test	Use when a repeat measurement is performed on the same day to confirm a prior result.
`52`	Reduced service	Use when the test is partially completed or performed at reduced volume/complexity.
`53`	Discontinued procedure	Use when specimen collection or testing was started but discontinued for documented clinical reasons.
`59`	Distinct procedural service	Use to indicate a distinct service when separate unrelated services occur the same day (use cautiously with laboratory codes).
`78`	Unplanned return to the operating/procedure room	Not typically used for routine chemistry but may apply if re-entry is required during a procedure that prompted STAT testing.
`80`	Assistant surgeon	Not applicable to this lab test but included when surgical assistance is billed; rarely relevant.
`91`	Repeat lab test (duplicate entry)	Duplicate of above; when repeat testing is clinically indicated to verify results.
`QW`	CLIA waived test	Use when the test is performed using a CLIA-waived method; applicable if the total cholesterol method used is CLIA-waived.
`TC`	Technical component	Use if only the technical component of the test is billed (instrumentation, technician time) and professional component is reported separately.
`90`	Outside lab (duplicate entry)	Indicates testing performed by an external laboratory; use when specimens are referred out.
`91`	Repeat measurement (consolidated)	Use for repeat testing to ensure reliability of a prior value.
`62`	Two surgeons	Not applicable to a lab test but retained for completeness when multiple providers are involved in a procedure requiring billing modifiers.

Taxonomy Code	Specialty	Notes
208100000X	Family Medicine	Primary care clinicians commonly order `82465` as part of cardiovascular risk assessment.
207Q00000X	Internal Medicine	Internists order and interpret lipid testing for chronic disease management.
207R00000X	Cardiovascular Disease	Cardiologists use total cholesterol results in risk stratification and treatment planning.
363A00000X	Clinical Laboratory	Medical laboratory personnel and pathologists perform and oversee the analytic testing.
207L00000X	Endocrinology	Endocrinologists monitor lipids in patients with metabolic disorders.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E78.0`	Pure hypercholesterolemia	Primary indication for measuring total cholesterol to diagnose and monitor elevated cholesterol.
`E78.5`	Hyperlipidemia, unspecified	General screening and management of dyslipidemia use total cholesterol testing.
`I10`	Essential (primary) hypertension	Hypertensive patients undergo lipid testing for cardiovascular risk assessment.
`E78.2`	Mixed hyperlipidemia	Total cholesterol measurement contributes to evaluating mixed lipid disorders.
`E78.1`	Pure hyperglyceridemia	Triglycerides and total cholesterol together inform diagnosis and treatment planning.
`Z13.6`	Encounter for screening for cardiovascular disorders	Routine screening includes measurement of total cholesterol as part of risk assessment.
`E03.9`	Hypothyroidism, unspecified	Thyroid dysfunction affects lipid metabolism; total cholesterol is monitored in management.
`E66.9`	Obesity, unspecified	Obesity is a risk factor for dyslipidemia; clinicians often order cholesterol testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80061`	Lipid panel; total cholesterol, HDL cholesterol, and triglycerides (may include calculation of VLDL and LDL)	Commonly ordered together with `82465` when a full lipid profile is needed; `82465` is the single-analyte total cholesterol component of broader panels.
`82465`	Cholesterol, total	The single-analyte test described; used when only total cholesterol measurement is required.
`83718`	Lipoprotein, direct LDL cholesterol	Performed when direct LDL measurement is required instead of calculated LDL from total cholesterol and triglycerides.
`84478`	Triglycerides	Often ordered alongside total cholesterol to complete cardiovascular risk assessment and calculate LDL.
`83721`	Lipoprotein, particle number (e.g., ApoB or LDL particle)	May be ordered for advanced lipid testing when additional risk stratification beyond total cholesterol is needed.
`36415`	Collection of venous blood by venipuncture	The specimen collection procedure typically performed prior to `82465` testing.

CPT 82009: Qualitative Ketone Bodies Test

CPT-82010-QUANTITATIVE-KETONE-BODIES-ASSAY-SERUM-PLASMA

CPT 82010: Quantitative Ketone Bodies Assay, Serum or Plasma

CPT-82013-ACETYLCHOLINESTERASE-QUANTITATIVE-ASSAY

CPT 82013: Quantitative Acetylcholinesterase (Acetylhydrolase) Assay

CPT-82016-QUALITATIVE-ACYLCARNITINES-METABOLIC-SCREEN

CPT 82016: Qualitative Acylcarnitines Metabolic Screen

CPT-82017-QUANTITATIVE-ACYLCARNITINE-ANALYSIS

CPT 82017: Quantitative Acylcarnitine Analysis

CPT-82024-QUANTITATIVE-CORTICOTROPIN-ACTH-ASSAY

CPT 82024: Quantitative Corticotropin (ACTH) Assay

CPT-82030-QUANTITATIVE-CAMP-PLASMA-URINE-ASSAY

CPT 82030: Quantitative cAMP Assay on Plasma or Urine

CPT-82040-QUANTITATIVE-ALBUMIN-MEASUREMENT

CPT 82040: Quantitative Albumin Measurement in Blood

CPT-82042-QUANTITATIVE-ALBUMIN-NONBLOOD-FLUID

CPT 82042: Quantitative Albumin in Non-Blood Body Fluid

CPT-82043-URINE-ALBUMIN-QUANTITATION-KIDNEY-DISEASE

CPT 82043: Urine Albumin Quantitation for Kidney Disease

Showing 1–10 of 411

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

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.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when reporting only the professional interpretation component if applicable to lab services that have separate technical/professional components (rare for automated chemistry).
`90`	Reference (outside) laboratory	Use when the specimen is sent to an outside/reference laboratory for completion of the test.
`91`	Repeat clinical diagnostic laboratory test	Use when a repeat measurement is performed on the same day to confirm a prior result.
`52`	Reduced service	Use when the test is partially completed or performed at reduced volume/complexity.
`53`	Discontinued procedure	Use when specimen collection or testing was started but discontinued for documented clinical reasons.
`59`	Distinct procedural service	Use to indicate a distinct service when separate unrelated services occur the same day (use cautiously with laboratory codes).
`78`	Unplanned return to the operating/procedure room	Not typically used for routine chemistry but may apply if re-entry is required during a procedure that prompted STAT testing.
`80`	Assistant surgeon	Not applicable to this lab test but included when surgical assistance is billed; rarely relevant.
`91`	Repeat lab test (duplicate entry)	Duplicate of above; when repeat testing is clinically indicated to verify results.
`QW`	CLIA waived test	Use when the test is performed using a CLIA-waived method; applicable if the total cholesterol method used is CLIA-waived.
`TC`	Technical component	Use if only the technical component of the test is billed (instrumentation, technician time) and professional component is reported separately.
`90`	Outside lab (duplicate entry)	Indicates testing performed by an external laboratory; use when specimens are referred out.
`91`	Repeat measurement (consolidated)	Use for repeat testing to ensure reliability of a prior value.
`62`	Two surgeons	Not applicable to a lab test but retained for completeness when multiple providers are involved in a procedure requiring billing modifiers.

Taxonomy Code	Specialty	Notes
208100000X	Family Medicine	Primary care clinicians commonly order `82465` as part of cardiovascular risk assessment.
207Q00000X	Internal Medicine	Internists order and interpret lipid testing for chronic disease management.
207R00000X	Cardiovascular Disease	Cardiologists use total cholesterol results in risk stratification and treatment planning.
363A00000X	Clinical Laboratory	Medical laboratory personnel and pathologists perform and oversee the analytic testing.
207L00000X	Endocrinology	Endocrinologists monitor lipids in patients with metabolic disorders.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`E78.0`	Pure hypercholesterolemia	Primary indication for measuring total cholesterol to diagnose and monitor elevated cholesterol.
`E78.5`	Hyperlipidemia, unspecified	General screening and management of dyslipidemia use total cholesterol testing.
`I10`	Essential (primary) hypertension	Hypertensive patients undergo lipid testing for cardiovascular risk assessment.
`E78.2`	Mixed hyperlipidemia	Total cholesterol measurement contributes to evaluating mixed lipid disorders.
`E78.1`	Pure hyperglyceridemia	Triglycerides and total cholesterol together inform diagnosis and treatment planning.
`Z13.6`	Encounter for screening for cardiovascular disorders	Routine screening includes measurement of total cholesterol as part of risk assessment.
`E03.9`	Hypothyroidism, unspecified	Thyroid dysfunction affects lipid metabolism; total cholesterol is monitored in management.
`E66.9`	Obesity, unspecified	Obesity is a risk factor for dyslipidemia; clinicians often order cholesterol testing.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`80061`	Lipid panel; total cholesterol, HDL cholesterol, and triglycerides (may include calculation of VLDL and LDL)	Commonly ordered together with `82465` when a full lipid profile is needed; `82465` is the single-analyte total cholesterol component of broader panels.
`82465`	Cholesterol, total	The single-analyte test described; used when only total cholesterol measurement is required.
`83718`	Lipoprotein, direct LDL cholesterol	Performed when direct LDL measurement is required instead of calculated LDL from total cholesterol and triglycerides.
`84478`	Triglycerides	Often ordered alongside total cholesterol to complete cardiovascular risk assessment and calculate LDL.
`83721`	Lipoprotein, particle number (e.g., ApoB or LDL particle)	May be ordered for advanced lipid testing when additional risk stratification beyond total cholesterol is needed.
`36415`	Collection of venous blood by venipuncture	The specimen collection procedure typically performed prior to `82465` testing.

CPT 82009: Qualitative Ketone Bodies Test

CPT-82010-QUANTITATIVE-KETONE-BODIES-ASSAY-SERUM-PLASMA

CPT 82010: Quantitative Ketone Bodies Assay, Serum or Plasma

CPT-82013-ACETYLCHOLINESTERASE-QUANTITATIVE-ASSAY

CPT 82013: Quantitative Acetylcholinesterase (Acetylhydrolase) Assay

CPT-82016-QUALITATIVE-ACYLCARNITINES-METABOLIC-SCREEN

CPT 82016: Qualitative Acylcarnitines Metabolic Screen

CPT-82017-QUANTITATIVE-ACYLCARNITINE-ANALYSIS

CPT 82017: Quantitative Acylcarnitine Analysis

CPT-82024-QUANTITATIVE-CORTICOTROPIN-ACTH-ASSAY

CPT 82024: Quantitative Corticotropin (ACTH) Assay

CPT-82030-QUANTITATIVE-CAMP-PLASMA-URINE-ASSAY

CPT 82030: Quantitative cAMP Assay on Plasma or Urine

CPT-82040-QUANTITATIVE-ALBUMIN-MEASUREMENT

CPT 82040: Quantitative Albumin Measurement in Blood

CPT-82042-QUANTITATIVE-ALBUMIN-NONBLOOD-FLUID

CPT 82042: Quantitative Albumin in Non-Blood Body Fluid

CPT-82043-URINE-ALBUMIN-QUANTITATION-KIDNEY-DISEASE

CPT 82043: Urine Albumin Quantitation for Kidney Disease

Showing 1–10 of 411

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 82465: Total Cholesterol Measurement in Serum or Whole Blood

Sign up for cpt 82465 policy alerts

Billing Code Overview

OpenPayer

CPT 82465: Total Cholesterol Measurement in Serum or Whole Blood

Sign up for cpt 82465 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References