How much does Medicare pay for CPT 80178?

Medicare allowed an average of $6.47 per service and paid $6.47 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $54.28, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 80178?

Lithium level. It was billed 58,771 times to 31,079 Medicare beneficiaries by 213 providers in 2024.

Does 80178 pay differently in an office than a hospital?

Yes. The allowed amount averaged $6.47 in an office setting and $5.85 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 80178 most?

Clinical Laboratory, with 58,614 services from 208 clinicians. Next are Pathology, Psychiatry.

CPT 80178

Lithium level

$6.47Medicare-allowed amount per service, averaged across 58,771 services

Providers submitted

$54.28

Asking price, not received

Medicare allowed

$6.47

The fee schedule figure

Medicare paid

$6.47

Balance is patient coinsurance

Providers submitted an average of $54.28 for this code and Medicare allowed $6.47 — 8.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $6.47 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $6.47
Hospital / facility: $5.85

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 58,704 services were billed in an office setting and 67 in a facility.

Services: 58,771
Beneficiaries: 31,079
Providers billing it: 213
Total allowed: $380,248

What Medicare pays for CPT 80178

Across 58,771 services billed by 213 providers to 31,079 beneficiaries, Medicare allowed an average of $6.47 per service. That is 1.9 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 80178

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	58,614	30,986	$6.47	208
Pathology	133	82	$6.45	4
Psychiatry	24	11	$6.48	1

80178 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New Jersey	8,128	$6.48	$6.48	11
California	7,290	$6.48	$6.48	23
North Carolina	5,552	$6.47	$6.48	5
Florida	4,184	$6.48	$6.48	12
Ohio	3,783	$6.48	$6.48	8
Texas	3,402	$6.47	$6.48	15
Massachusetts	3,035	$6.48	$6.48	6
Illinois	2,426	$6.46	$6.48	8
Kansas	2,241	$6.48	$6.48	5
Nevada	1,662	$6.48	$6.48	3
Washington	1,621	$6.47	$6.48	5
New York	1,616	$6.47	$6.48	7
Pennsylvania	1,322	$6.48	$6.48	9
Oklahoma	1,268	$6.48	$6.48	6
Arizona	1,195	$6.48	$6.48	3
Alabama	1,108	$6.46	$6.48	3
Georgia	1,089	$6.48	$6.48	4
Maryland	940	$6.48	$6.48	6
Tennessee	886	$6.44	$6.48	5
Colorado	780	$6.47	$6.48	5
Louisiana	616	$6.48	$6.48	4
Wisconsin	553	$6.38	$6.48	5
Oregon	541	$6.42	$6.48	5
Virginia	482	$6.45	$6.48	6
Kentucky	422	$6.48	$6.48	3
Michigan	405	$6.43	$6.48	7
Minnesota	263	$6.44	$6.48	5
Missouri	213	$6.48	$6.48	3
Utah	194	$6.48	$6.48	2
New Mexico	187	$6.48	$6.48	2
Iowa	166	$6.41	$6.48	4
South Dakota	163	$6.48	$6.48	1
Rhode Island	158	$6.48	$6.48	2
Hawaii	141	$6.48	$6.48	2
Maine	124	$6.48	$6.48	1
Indiana	121	$6.43	$6.48	2
North Dakota	110	$6.45	$6.48	2
Idaho	87	$6.48	$6.48	1
Mississippi	65	$6.48	$6.48	1
South Carolina	61	$6.48	$6.48	2
Connecticut	56	$6.37	$6.48	1
Nebraska	50	$6.48	$6.48	1
Arkansas	44	$6.48	$6.48	1
Delaware	21	$6.48	$6.48	1

Related codes

80197Tacrolimus level$13.41
80164Valproic acid level$13.26
80177Levetiracetam level$12.97
80162Digoxin level$13.00
80185Phenytoin level$12.97
80156Carbamazepine level$14.27
80159Clozapine level$19.74
80175Lamotrigine level$12.97
80158Cyclosporine level$17.64
80195Sirolimus level$13.42
80184Phenobarbital level$14.94
80165Valproic acid level$13.26

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.