CPT 80061
Lipid panel
A cholesterol panel: total cholesterol, HDL, LDL and triglycerides. Usually part of a routine physical or a cardiovascular check rather than an ER test.
Billed to Medicare
$36
What providers submitted, on average, for this code in a hospital setting.
Medicare accepted
$13
What Medicare treated as payable. Not a commercial rate or a cash price.
The gap
2.7x
How many times the accepted amount the billed figure was.
National averages from the Centers for Medicare & Medicaid Services, 2024 data, retrieved 2026-09-14. Medicare fee-for-service, physician and practitioner claims only. The hospital's own charge for the same code is separate and is usually higher. Based on 2,046 services.
Among the 10 lab tests codes on this site with CMS figures, this gap ranks 9 of 10 (median 3.7x). The widest is Urinalysis, automated with microscopy at 5.5x.
Where this line goes wrong
Preventive or diagnostic
As a screening test at a preventive visit, most plans cover it with no cost sharing. If it was billed as diagnostic, it goes against your deductible. The diagnosis code on the claim decides which, and it can be corrected.
Components billed separately
Total cholesterol (82465), HDL (83718) and triglycerides (84478) billed alongside the panel are duplicates.
Check it, then ask
- 1
If the test was part of an annual physical, ask the provider to check the diagnosis code and rebill it as preventive if appropriate.
- 2
Ask for the itemized bill and the lab results and match every billed test to a result.
- 3
Check for a panel billed alongside one of its own components, or two overlapping panels on the same draw.
- 4
Count the blood draw (36415) lines; one per visit is the norm.
- 5
If self-pay, ask for the hospital's cash price for each test, or compare with an independent lab's published price.
The full walkthrough for this kind of bill: Your bill came in above the estimate.
For $49, a mediloop specialist reads your itemized bill and EOB, if available, checks every code against the record and available pricing, flags the lines to dispute, and prepares a step-by-step plan with the exact wording to send. It appears in your account within 24 hours after all required documents arrive.
Get the plan for your billNot sure the bill is worth fighting? Run the free savings calculator first
Codes that travel with this one
People also ask
Why did my cholesterol test cost money when my physical was free?
Usually because the lab claim carried a diagnostic rather than a preventive diagnosis code. Ask the provider's office to review and resubmit it.
Sources
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.