What's a fair price for CPT 80061?

Most patients should expect to pay no more than 2–3× the Medicare allowable for the same service. Medicare's allowable rate for 80061 is roughly $13, which is a useful fair-price anchor. A reasonable target when negotiating cash-pay or self-pay is somewhere between the Medicare rate and the in-network allowed amount your insurer would pay.

How do I dispute CPT 80061?

Request a fully itemized bill with CPT codes and your EOB. For 80061 specifically, the most common issues are preventive, unbundling. Write a short dispute letter to the provider's billing office listing the specific line items you're contesting and the reason; federal and state law require them to investigate and pause collections while the dispute is open. Or upload the bill to patientbill.org and we'll do the dispute letter for you — we only get paid if we lower your bill.

Why is CPT 80061 on my bill?

Lipid panel (cholesterol). It appears on bills when a service was performed in a lab setting and the provider documented enough work to support this specific code. If the description doesn't match what you remember happening at your visit, ask for the chart note that supports the code.

CPT code

80061 — Lipid panel (cholesterol)

Plain-English reference for CPT 80061. What it covers, what it typically costs, and the billing errors patientbill.org looks for on this code.

Typical setting: Lab
Medicare allowable: $13
Common private-payer range: $40 – $250

The Medicare allowable is the national non-facility rate from the CMS Physician Fee Schedule and is the most defensible "fair price" anchor. Commercial charges typically run 2–5× this number; hospital list prices can be much higher still.

What this code actually is

CPT 80061 is the Lipid Panel — total cholesterol, HDL, LDL, triglycerides. Often unbundled into 82465 / 83718 / 84478. Also worth checking: when run as part of an annual physical, the lipid panel is a preventive service and should be covered at $0 by most insurance — any patient balance is worth disputing.

Audit issues we look for on 80061

Preventive miscoding — service is ACA-preventive but billed with patient cost-sharing
Unbundling — individual sub-tests billed separately when they should be one panel charge

Think your bill has the wrong 80061 charge?

Upload the bill and we'll check for upcoding, unbundling, duplicates, and prices above what's reasonable. If we recover money for you, we keep a small contingency fee. If we don't, you owe nothing.

Common questions about CPT 80061

Private-payer charges typically fall in the $40 – $250 range, though hospital list prices can run much higher. Medicare's allowable rate for 80061 is roughly $13, which is a useful fair-price anchor. If your bill for this code is significantly above the high end of that range, ask for an itemized statement and compare against your Explanation of Benefits (EOB) — the insurance "allowed amount" is the most defensible reference point.

Related codes in Lab panels & blood tests

Patientbill.org is not affiliated with any provider, insurer, or the AMA. Code descriptions are CMS-published short descriptors plus our own plain-English explanations; pricing references are from the CMS Medicare Physician Fee Schedule and public charge benchmarks and may be outdated. Verify your specific charges against your EOB.