Cortisol, Total, LC/MS

For Specimen Integrity during Extreme Weather see the “Lockbox Usage in Extreme Weather” document at the top of this page.

Test Code

CPT Codes

Preferred Specimen
1 mL serum collected in a red-top tube (no gel)

Minimum Volume
0.2 mL

Other Acceptable Specimens
Plasma collected in: EDTA (lavender-top) tube

Specify time of day specimen was collected.

Transport Temperature
Room temperature

Specimen Stability
Room temperature: 14 days
Refrigerated: 21 days
Frozen: 1 year

Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Gross hemolysis • Received room temperature • Serum separator tubes (SST)

Chromatography/Mass Spectrometry

FDA Status
This test was developed and its analytical performance characteristics have been determined by Quest Diagnostics. It has not been cleared or approved by the U.S. Food and Drug Administration. This assay has been validated pursuant to the CLIA regulations and is used for clinical purposes.

Setup Schedule
Set up: Mon-Fri; Report available: 3-7 days

Reference Range
Adult Reference Ranges for Cortisol, Total:

8-10 AM 4.6-20.6 mcg/dL
4-6 PM 1.8-13.6 mcg/dL

Cortisol Response to ACTH
Peak >20.0 mcg/dL
Peak >16.0 mcg/dL after IM injection

Pediatric Reference Ranges for Cortisol, Total:
Age (mcg/dL)
Premature Infants (31-35 weeks): ≤15.0
Term Infants, 3 days old: ≤14.0
< 30 days: No range established
1-11 months: 1.4-24.0
1 year: 1.7-25.4
2 years: 1.8-26.4
3 years: 2.0-27.0
4 years: 2.0-27.2
5 years: 2.0-27.3
6 years: 2.0-27.2
7 years: 2.0-27.1
8 years: 2.0-27.0
9 years: 1.9-26.8
10 years: 1.9-26.4
11 years: 1.8-26.1
12 years: 1.8-26.0
13 years: 1.8-26.1
14 years: 1.9-26.6
15 years: 2.1-27.5
16 years: 2.3-28.6
17 years: 2.6-29.8

Pediatric lower reference values are reflective of both AM and early PM sampling

ACTH                     Baseline                60 Minutes
Stimulation**        (mcg/dL)                (mcg/dL)
1-12 Months          3.0-23.0                 32.0-60.0

Clinical Significance
Total cortisol concentrations are decreased in Addison's Disease and increased in Cushing's Disease and in other conditions of glucocorticoid excess.

Performing Laboratory
Quest Diagnostics Nichols Institute-San Juan Capistrano, CA
33608 Ortega Highway
San Juan Capistrano, CA 92675-2042

Last Updated: November 29, 2021

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.