Understanding: What is the cut-off level for oxycodone? in Drug Testing

October 12, 2025 •

4 min read

According to the U.S. Department of Transportation (DOT), the standard initial and confirmatory cutoff level for oxycodone in a urine drug test is 100 nanograms per milliliter (ng/mL). This established threshold helps standardize screening, but the specific requirements for what is the cut-off level for oxycodone can vary depending on the testing context and the type of laboratory analysis used.

Quick Summary

The cut-off level for oxycodone in drug tests varies based on the testing method, ranging from a standard 100 ng/mL for many workplace urine screens to lower thresholds for more sensitive confirmatory tests. Factors like dosage, metabolism, and time since last use also affect detectability.

Key Points

Standard Cut-Off: For many federal and workplace urine tests, the oxycodone cut-off level is 100 ng/mL for both initial screening and confirmatory testing.
Clinical Variations: Clinical laboratories and specific confirmatory tests often use lower, more sensitive cut-off levels, which can range from 50 ng/mL to 25 ng/mL.
Two-Step Process: Initial positive immunoassay screens are followed by more specific and accurate confirmatory tests, like GC-MS or LC-MS/MS, especially when lower thresholds are used.
Detection Window Differences: The time oxycodone is detectable depends on the sample. Urine tests typically detect it for 1–4 days, while hair tests can detect it for up to 90 days.
Not an Opiate Screen: Routine opiate immunoassay screens are often insensitive to oxycodone, meaning a specific oxycodone test is required to ensure accurate detection.
Result Interpretation: Interpretation of test results should always consider the specific testing methodology and cut-off levels, especially in cases of prescribed use.

The Significance of Drug Test Cut-Off Levels

Cut-off levels, or thresholds, are a fundamental component of drug testing. They determine the minimum concentration of a drug or its metabolite that must be present in a biological sample to be considered a positive result. This system helps differentiate between low-level, incidental exposure and actual drug use, while also guarding against false positives. For a substance like oxycodone, an opioid painkiller, establishing clear and consistent cut-off levels is crucial for accurate and fair testing.

The testing process for oxycodone in urine typically involves two main stages: an initial immunoassay screening and a more specific confirmatory test for any samples that screen positive. Each stage has its own unique cutoff concentration.

Standard Cut-Off Levels for Oxycodone

The most widely recognized standard for oxycodone testing in the United States comes from federal guidelines for workplace drug testing. For example, the Department of Transportation (DOT) specifies the following cut-offs for urine tests:

Initial Screen: 100 ng/mL for oxycodone/oxymorphone.
Confirmatory Test: 100 ng/mL for oxycodone/oxymorphone.

This standard is adopted by many other institutions and private employers. A result below this threshold is considered negative, while a result above it is reported as positive. If the initial immunoassay returns a positive result, the sample is then sent for a more precise confirmatory test, typically Gas Chromatography-Mass Spectrometry (GC-MS) or Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS), to confirm the presence of oxycodone and rule out potential interferences.

Variations in Cut-Off Levels

While the 100 ng/mL standard is common, it's important to understand that not all labs or testing situations adhere to the same protocol. Cut-off levels can vary based on the specific laboratory, the type of test being performed (e.g., workplace versus clinical pain management), and the sensitivity of the testing equipment. For instance, clinical settings or more sensitive confirmatory tests might use lower thresholds to detect trace amounts of the drug, which can be useful for monitoring patient compliance.

Commonly observed variations in oxycodone cut-off levels:

Some clinical quantitative tests: May utilize lower thresholds, with some labs citing cutoffs of 50 ng/mL or even 25 ng/mL using highly sensitive LC-MS/MS methods.
Rapid on-site tests: The sensitivity of these tests can sometimes differ from laboratory-based assays, though many are calibrated to the 100 ng/mL standard.

Factors Influencing Oxycodone Detection

Beyond the established cut-off level, several other factors influence whether a person will test positive for oxycodone. The body's metabolism and excretion of the drug can be affected by individual physiology and drug usage patterns.

Metabolism: How quickly an individual's body processes oxycodone varies due to factors like age, liver function, and genetics. Slower metabolizers may have detectable levels for longer.
Dosage and Frequency: The amount of oxycodone taken and how often it is used significantly impacts detection time. High doses and chronic use can lead to accumulation in the body, extending the detection window.
Hydration: Diluted urine, caused by excessive water intake, can lower the drug concentration below the test's cut-off level, potentially leading to a false negative. Laboratories are trained to check for dilution and may invalidate such samples.
Type of Test: Different samples have different detection windows.
- Urine: Typically 1 to 4 days for occasional use, possibly longer for chronic use.
- Blood: Up to 24 hours.
- Saliva: Up to 48 hours.
- Hair Follicle: Up to 90 days.

Comparison of Oxycodone Testing Methods


Feature	Initial Immunoassay Screen	Confirmatory (GC-MS/LC-MS/MS) Test
Purpose	Rapid, cost-effective, presumptive screening for many substances.	High-accuracy, specific confirmation of drug presence and concentration.
Oxycodone Cut-Off	Often 100 ng/mL.	Varies, can be 100 ng/mL (standard) or lower (50 ng/mL, 25 ng/mL) depending on lab sensitivity.
Principle	Uses antibodies to detect drug or metabolite.	Separates chemical components for precise identification.
Cross-Reactivity	Potential for false positives due to similar drug structures.	Very low cross-reactivity; identifies specific drug.
Result	Reported as positive or negative for the class of drugs.	Confirms presence of specific drugs and reports quantitative concentration.
Sample	Urine (most common).	Urine, blood, other biological fluids.

The Importance of Understanding Test Interpretation

For patients taking prescribed oxycodone, testing positive is an expected outcome. However, understanding the specific cut-off levels is vital for interpreting results accurately. As documented by Mayo Clinic Laboratories, a patient might test "negative" on a standard opiate immunoassay screen, which often targets morphine, but then test "positive" for oxycodone on a more specific confirmatory test with a different, lower threshold. This highlights the importance of specific testing for oxycodone rather than relying on broader opiate screens. Unexpected results should always be interpreted by a medical professional who can consider prescription status, testing methodology, and the patient's full clinical history.

Conclusion

In conclusion, what is the cut-off level for oxycodone? depends largely on the context of the test and the laboratory performing the analysis. For many workplace and federally regulated drug screens, the standard is 100 ng/mL for both initial and confirmatory urine tests. However, more sensitive clinical lab tests may use lower cut-offs (e.g., 50 ng/mL or 25 ng/mL), and detection windows vary significantly between urine, blood, saliva, and hair samples. Accurate interpretation of a drug test result requires understanding these variables, including the specific test method and the concentration threshold used, rather than relying on a single, universal number. Always consult with a healthcare provider or drug testing expert for clarification on specific results and testing procedures.

Frequently Asked Questions

For federal and many private workplace drug tests, the standard urine cut-off level for oxycodone is 100 ng/mL for both the initial screening and the confirmatory test.

Yes, different laboratories may use different cut-off levels depending on the test type, the technology used, and the clinical or regulatory context. For example, some quantitative clinical tests may use thresholds as low as 50 ng/mL or 25 ng/mL.

Urine tests are the most common method for routine screening and can detect oxycodone for up to a few days. However, hair follicle tests offer a much longer detection window of up to 90 days for assessing chronic use.

Not necessarily. Routine opiate immunoassay screens are often designed to detect morphine and codeine and may not be sensitive enough to detect oxycodone. A specific oxycodone test is typically required for accurate detection.

The initial screen provides a presumptive result using a specific cut-off, often 100 ng/mL. If positive, a more precise confirmatory test is performed to identify the specific drug and its concentration, which may sometimes use a different, more sensitive cut-off depending on the lab.

The detection time for oxycodone varies based on the test type. It can be detected in blood for up to 24 hours, in saliva for up to 48 hours, and in urine for 1–4 days. Hair tests can detect use for up to 90 days.

While passive exposure is highly unlikely to cause a positive result at the standard 100 ng/mL cut-off, this threshold is designed to prevent false positives from incidental contact. Factors like dosage and individual metabolism are far more significant.