Prostate Specific Antigen, Total with Reflex to Free PSA (Includes Free Percentage)
0080264
Ordering Recommendation
Do not use for initial prostate cancer screening; preferred test is total prostate specific (PSA) antigen (0070121) in conjunction with digital rectal exam (DRE). May be useful in distinguishing cancer from benign conditions in patients with mildly elevated total PSA and negative DRE.
Mnemonic
TPSAR
Methodology
Quantitative Electrochemiluminescent Immunoassay
Performed
Sun-Sat
Reported
Within 24 hours  
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Specimen Required
Patient Preparation
  
Collect
Plasma separator tube or serum separator tube. Also acceptable: Plain red, green (sodium or lithium heparin), lavender (EDTA), or pink (K2EDTA).  
Specimen Preparation
Allow specimen to clot completely at room temperature. Separate serum or plasma from cells ASAP or within 2 hours of collection. Transfer 1 mL serum or plasma to an ARUP Standard Transport Tube. (Min: 0.5 mL)  
Storage/Transport Temperature
Frozen.  
Unacceptable Conditions
Grossly hemolyzed specimens. Vaginal washings.  
Remarks
  
Stability
After separation from cells: Ambient: 8 hours; Refrigerated: 48 hours; Frozen: 3 months  
Reference Interval
Refer to report.
 
Test Number Components Reference Interval
 Prostate Specific Antigen, Total 0.0-​4.0 ng/mL
 Prostate Specific Antigen, Free By report
 Prostate Specific Antigen Percent Free By report
Interpretive Data
 
Note
If PSA Total is between 3.0-10.0 ng/mL, then Free PSA testing will be added. Additional charges apply.

The Free PSA percentage is calculated using results of the Total and Free PSA tests.
CPT Code(s)
84153; if reflexed, add 84154
Components
Component Test Code*Component Chart NameLOINC
0080286Prostate Specific Antigen, Reflex2857-1
0080287Prostate Specific Antigen, Free, Reflex10886-0
0080288Prostate Specific Antigen-Pct Free, Rflx12841-3
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • Free PSA
  • Free Ratio Reflex
  • PSA Free/Total Ratio
  • PSA ratio
  • PSA Total
  • PSA Total and Free
  • Total PSA