CPT code 78267: Urea breath test, carbon-14 sample acquisition2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Acquisition of exhaled breath samples for carbon-14 urea breath testing, used to evaluate Helicobacter pylori infection.
Medicare pays $11.06 for 78267 under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$11.06
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 8 sections
What 78267 covers
Code 78267 captures exhaled breath samples for a carbon-14 urea breath test. The test is used in evaluating Helicobacter pylori infection; this code represents acquisition of the samples for analysis, rather than analysis itself. The carbon-14 pathway is distinct from carbon-13 urea breath testing. Report 78267 for the sample-acquisition portion, with 78268 used for analysis when that service is performed.
Medicare pays 78267 only through the Clinical Laboratory Fee Schedule (CLFS). The CLFS uses one national amount for this code across localities, without a geographic adjustment or office-versus-facility difference; the 2026 amount is $11.06, unchanged since 2020. The code is excluded from the physician fee schedule. Report 78268 separately when analysis is also performed.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 78267
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 78267. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Excluded from the physician fee schedule
The physician fee schedule lists 78267 with status X (excluded by statute), so the test itself is paid only from the CLFS.
78267 on the lab fee schedule since 2020
78267 · CLFS 2026 Q4 (current)
$11.06
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
78267 compared with similar tests
- 78268Urea breath testC-14 analysis$94.41
- Use 78267 for acquiring carbon-14 breath samples and 78268 for analyzing them. They represent distinct services in the same test.
- 83014H pylori doseFor carbon-13 testing$7.86
- 83014 is the drug-administration and sample-collection service for the carbon-13 pathway; 78267 is carbon-14 sample acquisition.
- 83013H. pylori Breath TestCarbon-13 urease analysis$67.36
- 83013 reports analysis in the carbon-13 pathway. Code 78267 reports sample acquisition for the carbon-14 pathway.
78267 billing questions
How does 78267 differ from 78268?
78267 reports acquisition of breath samples for the carbon-14 test. Code 78268 reports analysis of those samples.
Can 78267 and 78268 be reported together?
They represent separate acquisition and analysis services and may be reported together when both are performed.
What documentation supports 78267?
Document the carbon-14 urea breath test and acquisition of its exhaled breath samples. Keep the sample-acquisition service distinct from analysis.
How does Medicare pay 78267?
Medicare pays 78267 through the CLFS at one national amount across localities, with no office-versus-facility difference. The code is excluded from the physician fee schedule.
How does 78267 differ from the carbon-13 breath-test services?
78267 reports sample acquisition for the carbon-14 pathway. Codes 83014 and 83013 describe drug administration and sample collection, and analysis, respectively, for the carbon-13 pathway.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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