Update Type: New Tests
Test Updated: 03/15/2023
Test Overview
Test Methodology

liquid chromatography mass spectrometry (LC-MS/MS)

Test Usage

Measurement of midnight/late-night salivary cortisol (LNSC) is used for screening of adrenal hyperfunction (Cushing syndrome). Although other cortisol tests may be ordered for the initial workup, LNSC has a superior sensitivity to plasma and 24-hour urinary free cortisol measurements. A positive LNSC result (≥ 100 ng/dL) should be followed by a second test for cortisol which may include LNSC, 24-hour urinary cortisol or dexamethasone suppression testing. Two positive LNSC may be used to confirm Cushing Syndrome.

Reference Range *

ACOR is A.M. collection time 0700-0800 Reference range: 100-750 ng/dL
PCOR is P.M. collection time 1500-1700 Reference range: <401 ng/dL
MCOR is Midnight collection 2300-2400 Reference range: <100 ng/dL NOTE: THIS IS THE PREFERRED TIME OF COLLECTION
SACOR is any time outside of these time frames above

* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Test Details
Days Set Up
TBD depending on volume
Analytic Time

3 hours

Soft Order Code
MiChart Code
  • Salivary Cortisol
  • Salivary Cortisol
Chemical Pathology
Drug Analysis
Specimen Requirements

Centrifuge and freeze at -20 degrees C. Otherwise submit refrigerated unspun

Collection Instructions

Specific instructions are included in the collection kits

Normal Volume
0.40 mL
Minimum Volume
0.30 mL
Rejection Criteria
Blood contamination during the collection process can increase cortisol concentration as cortisol levels in blood are higher than in saliva. Samples appearing pink with blood should be rejected
CPT Code
Fee Code
ACOR 51494-3 PCOR 51493-5 MCOR 51492-7 SACOR 51495-0