CPT code 82040: Albumin assay, blood specimen2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures albumin in serum, plasma, or whole blood to evaluate circulating protein levels in settings such as liver disease, protein loss, or edema.
Medicare pays $4.95 for 82040 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
$4.95
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
- QW · CLIA-waived test
- $4.95
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 82040 covers
This assay measures albumin, a major circulating protein, in serum, plasma, or whole blood. Clinicians may order it when evaluating liver synthetic function, suspected protein loss, or edema. Hospital and independent laboratories typically perform and report the test from a submitted blood specimen; it may also be performed under a CLIA certificate of waiver when the waived version is used.
Report this code for the blood-specimen albumin assay, not urine albumin or albumin testing from another source. CMS lists modifier QW for the CLIA-waived version. Medicare pays the test only through the CLFS, at one national amount across all states and localities, with no office or facility payment difference. The 2026 national CLFS amount is $4.95, unchanged since 2020.
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 82040
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 82040. 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 82040 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 82040 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $4.95.
82040 on the lab fee schedule since 2020
82040 · CLFS 2026 Q4 (current)
$4.95
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.
82040 compared with similar tests
- 82042Fluid albuminCSF or amniotic fluid$7.78
- Use 82040 for serum, plasma, or whole blood. Use 82042 for quantitative albumin testing from another source.
- 82043Urine albuminQuantitative measurement$5.78
- 82040 is for blood-specimen albumin; 82043 is for quantitative urine albumin.
- 82044Urine albuminSemiquantitative$6.23
- 82044 reports semiquantitative urine albumin testing, unlike the blood-specimen assay reported with 82040.
- 82045Albumin ischemia testIschemia-modified protein$33.94
- 82045 measures ischemia-modified albumin, a different test from the albumin concentration assay reported with 82040.
82040 billing questions
When should this code be used instead of 82043?
Use 82040 for albumin measured in serum, plasma, or whole blood. Code 82043 is for quantitative urine albumin.
How does 82040 differ from 82042?
82040 describes albumin testing on blood specimens. 82042 is used for quantitative albumin testing from another source.
When is modifier QW appropriate?
CMS lists QW for the CLIA-waived version of this test. It identifies testing performed under a CLIA certificate of waiver.
Does Medicare pay this test through the physician fee schedule?
No. Medicare pays 82040 through the CLFS, using one national amount across localities and care settings.
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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