RVUs for Labs

February 1, 2004

Where do I find the relative value units (RVUs) for clinical laboratory CPT codes?

Question: Where do I find the relative value units (RVUs) for clinical laboratory CPT codes?

Answer: There are no RVUs for the majority of lab codes. Why?

Because Medicare, the entity that makes up the RVUs, considers them to be incident to the E&M code and therefore not payable.

If you're looking to set your fees, you'll need to evaluate the allowable that you see from your commercial carriers - then mark up the fees a bit and that's your charge.

For example, say 81000 pays zero from Medicare, zero from Medicaid, $12 from Cigna, and $18 from Blue Cross Blue Shield. Set your fee at $25 or so. (These numbers are hypothetical. You'll need to capture them for your carriers.)