Cortisol, Total : 367

Test Code

CORTC or 367

Alias/See Also

Hydrocortisone, Total Cortisol, Cortisol, Serum

CPT Codes
82533

Instructions

Collect blood in gold top gel barrier or plain red top tube. Allow blood to clot and centrifuge to separate serum
Required serum volume: 1 mL (minimum 0.5 mL)
It is recommended to collect specimens between 7AM to 9AM, and/or 3PM to 5PM since cortisol levels follow a diurnal pattern in healthy individuals.

Assay not recommended when patient is receiving prednisone/prednisolone therapy due to cross reactivity with the antibody used in this assay.

Transport Container

Preferred Specimen
1 mL serum
Minimum Volume
0.5 mL

Transport Temperature

Room temperature.

Specimen Stability

Room temperature: 7 days; Refrigerated: 7 days; Frozen: 28 days

Methodology
Immunoassay

Setup Schedule

Sunday - Saturday

Report Available

1 day

Reference Range

0-3 Days (infants)

Premature (31-35 Weeks) a.m. or p.m. ≤15.0 mcg/dL

Term a.m. or p.m. ≤14.0 mcg/dL

4 Days-1 Month a.m. or p.m. Not established

2-11 Months a.m. 3.0-23.0 mcg/dL; p.m. Not established

1-17 Years a.m. 3.0-25.0 mcg/dL; p.m. 3.0-17.0 mcg/dL

Adult 8 a.m. (7-9 a.m.) specimen 4.0-22.0 mcg/dL

Adult 4 p.m. (3-5 p.m.) specimen 3.0-17.0 mcg/dL

Clinical Significance

Cortisol is increased in Cushing's Disease and decreased in Addison's Disease (adrenal insufficiency). Emerging data has demonstrated that patients with difficult-to-treat Type II Diabetes (HbA1c >7.5% despite medication) may also have elevated cortisol levels, akin to Cushing's Disease; however, the physical manifestations are not as obvious, and prevalence is significantly higher.

1. Buse JB, Kahn SE, Aroda VR, et al. Prevalence of hypercortisolism in difficult-to-control type
2 diabetes. Diabetes Care. 2025;48(12):2012-2020 doi: 10.2337/dc24-2841 2. DeFronzo RA, Auchus RJ. Cushing Syndrome, hypercortisolism, and glucose homeostasis: a review. Diabetes. 2025;74(12):2168-2178. doi: 10.2337/db25-0120
3. Lundqvist MH, Pereira MJ, Almby K, et al. Regulation of the cortisol axis, glucagon, and growth hormone by glucose is altered in prediabetes and type 2 diabetes. J Clin Endocrinol Metab. 2024;109:e675-e688. doi: 10.1210/clinem/dgad549
4. Nieman LK, Biller BMK, Findling JW, et al. The diagnosis of Cushing's Syndrome: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008; 93: 1526-1540. doi: 10.1210/jc.2008-0125
5. DeFronzo RA, Fonseca V, Aroda VR, et al. Inadequately controlled type 2 diabetes and hypercortisolism: improved glycemia with mifepristone treatment. Diabetes Care. 2025;48(12):2036-2044. doi: 10.2337/dc25-1055

Performing Laboratory
med fusion

The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.