CPT 81003 Medicare Lab Fee Schedule 2026
Medicare's 2026 national Clinical Laboratory Fee Schedule payment for CPT 81003 is $2.25, unchanged from 2025.
- National
- $2.25
- vs. 2025
- No change
CMS code description
81003 national rate by year
Each row is the latest CMS file published that year. Change is against the year before.
| CMS file | National payment | Change |
|---|---|---|
| January 2026 | $2.25 | No change |
| January 2025 | $2.25 | No change |
| January 2024 | $2.25 | No change |
| January 2023 | $2.25 | No change |
| January 2022 | $2.25 | - |
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.
Open in the lookupSee what state Medicaid programs pay for 81003
50 state Medicaid agencies publish their own physician fee schedule. The 81003 page shows real published rates for several of them free, with effective dates and official sources.
17,674 codes and 974,327 published rates, taken from the files the state agencies publish themselves.
Commercial payers publish their negotiated rates for 81003 in transparency files. See how those compare with Medicare's rate.
Commercial rates for 81003Compare Medicare's rate for 81003 with published commercial rates
Search negotiated rates from more than 180 commercial payers by NPI, TIN, and ZIP code. Review historical rates or export the data through API, SQL, MCP, or bulk download.
Nearby codes
Methodology
Rates come from the CMS Clinical Laboratory Fee Schedule (CLFS), published quarterly. Each HCPCS payment amount reflects the national CLFS payment for outpatient laboratory services.
View CMS Clinical Laboratory Fee Schedule