CPT code 80402: ACTH stimulation, 21-hydroxylase deficiency2026 Medicare lab fee · Clinical Laboratory Fee Schedule
The ACTH stimulation panel assesses adrenal function for 21-hydroxylase deficiency with two cortisol and two 17-hydroxyprogesterone measurements.
Medicare pays $86.96 for 80402 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
$86.96
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 80402 covers
This ACTH stimulation panel assesses adrenal steroid response when 21-hydroxylase deficiency is being evaluated. It includes two cortisol measurements and two 17-hydroxyprogesterone measurements. The panel is specific to this adrenal assessment and includes both analytes rather than a single-analyte cortisol or 17-hydroxyprogesterone test.
Medicare pays 80402 through the Clinical Laboratory Fee Schedule (CLFS) at one national amount. The 2026 national CLFS amount is $86.96, unchanged since 2020. The amount applies in every state and locality, without geographic or office-versus-facility adjustment. The test is paid only through the CLFS and is excluded from the physician fee schedule by statute.
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 80402
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 80402. 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 80402 with status X (excluded by statute), so the test itself is paid only from the CLFS.
80402 on the lab fee schedule since 2020
80402 · CLFS 2026 Q4 (current)
$86.96
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.
80402 compared with similar tests
- 80400ACTH panelTwo cortisol measurements$32.62
- Both are ACTH stimulation panels. Use 80402 when assessing 21-hydroxylase deficiency with the specified cortisol and 17-hydroxyprogesterone measurements.
- 80406ACTH stimulation3-beta-HSD deficiency$78.26
- 80406 is another ACTH stimulation panel. Use 80402 for the panel assessing 21-hydroxylase deficiency.
- 8349817-OHP test$27.17
- 83498 is an individual 17-hydroxyprogesterone assay; 80402 is the ACTH stimulation panel that includes two measurements each of cortisol and 17-hydroxyprogesterone.
80402 billing questions
When should 80402 be selected instead of another ACTH stimulation panel?
Select 80402 for an ACTH stimulation panel assessing 21-hydroxylase deficiency, with cortisol and 17-hydroxyprogesterone measurements. Codes 80400 and 80406 are other ACTH stimulation panels.
Which analytes are included in 80402?
The panel includes two cortisol measurements and two 17-hydroxyprogesterone measurements.
Does the panel include two measurements of each analyte?
Yes. The panel specifies two measurements each of cortisol and 17-hydroxyprogesterone.
How does Medicare pay 80402?
Medicare pays 80402 through the CLFS at one national amount, with no geographic or office-versus-facility adjustment.
Is a physician interpretation separately payable under the physician fee schedule?
The test is paid only through the CLFS and is excluded from the physician fee schedule by statute.
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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