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CMS January 2026Clinical Laboratory Fee Schedule · Free lookup

CPT 84270 Medicare Lab Fee Schedule 2026

Medicare's 2026 national Clinical Laboratory Fee Schedule payment for CPT 84270 is $21.73, unchanged from 2025.

National rate, January 2026
National
$21.73
vs. 2025
No change
Commercial national avg.
$22.55

Filters

84270
20262025

Select one or more years

Up to 5 codes · 4 remaining

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Clinical Lab·84270·2026, 2025
Current rate
$21.73▲0.0%
Code description

Sex hormone binding globulin (protein) level

CodeYearModifierRateDescription
842702026none$21.73Sex hormone binding globulin (protein) level
842702025none$21.73Sex hormone binding globulin (protein) level

84270 national rate by year

Each row is the latest CMS file published that year. Change is against the year before.

CMS fileNational paymentChange
January 2026$21.73No change
January 2025$21.73No change
January 2024$21.73No change
January 2023$21.73No change
January 2022$21.73-

Since 2018 the Clinical Laboratory Fee Schedule pays one national amount per code, set from private-payer rates that laboratories report to CMS, so this figure is the same in every locality.

84270: Medicare vs. commercial national average

The commercial national average for 84270, the mean of what BCBS, UnitedHealthcare, Aetna and Cigna publish nationwide, is $22.55, 104% of Medicare's $21.73.

  • BCBS $18.31
  • UnitedHealthcare $15.62
  • Aetna $24.94
  • Cigna $31.34

A national average, not a local rate: each payer's figure averages the unmodified, in-network professional rates it publishes for 84270 across the country in its transparency files. Contracted rates vary widely by market, provider and plan. Medicare's figure is its national Clinical Laboratory Fee Schedule payment.

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