CPT code 82172: Apolipoprotein, each apolipoprotein measured2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures an apolipoprotein level to support assessment of dyslipidemia and cardiovascular risk, often alongside conventional lipid testing.
Medicare pays $21.09 for 82172 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
$21.09
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 82172 covers
This assay measures the level of an apolipoprotein. Common targets include apolipoprotein A-I and apolipoprotein B, which provide information about different aspects of lipoprotein-related cardiovascular risk. Clinicians may order it when assessing dyslipidemia or cardiovascular risk, often alongside a standard lipid panel. Clinical laboratories and office-based laboratories perform and report the test.
Report 82172 for each distinct apolipoprotein measured; when more than one analyte is tested, report each one. Medicare pays the assay under the Clinical Laboratory Fee Schedule (CLFS), not the physician fee schedule. The 2026 national CLFS amount is $21.09 and has been unchanged since 2020. One national amount applies in every state and locality, with no geographic or office-versus-facility adjustment.
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 82172
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 82172. 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 82172 with status X (excluded by statute), so the test itself is paid only from the CLFS.
82172 on the lab fee schedule since 2020
82172 · CLFS 2026 Q4 (current)
$21.09
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.
82172 compared with similar tests
- 80061Lipid panelCholesterol and triglycerides$13.39
- 80061 reports a standard lipid panel. Use 82172 for the apolipoprotein analyte; the two tests provide different measurements.
- 83718HDL cholesterolDirect measurement$8.19
- 83718 measures HDL cholesterol. 82172 measures an apolipoprotein, such as Apo A-I, rather than reporting HDL cholesterol itself.
- 83721LDL cholesterolDirect LDL measurement$10.50
- 83721 measures direct LDL cholesterol. 82172 measures an apolipoprotein, such as Apo B, and is not a direct LDL cholesterol assay.
82172 billing questions
When should 82172 be reported with a lipid panel?
Use 82172 for an apolipoprotein assay, such as Apo A-I or Apo B. A lipid panel reports conventional lipid measurements, so it does not replace an apolipoprotein assay when that test is performed.
How are units determined when more than one apolipoprotein is tested?
Report the code for each distinct apolipoprotein measured. For example, testing both Apo A-I and Apo B involves two different analytes.
Is 82172 paid under the physician fee schedule?
No. Medicare pays this laboratory test under the CLFS; the code is excluded from the physician fee schedule.
Does the Medicare payment vary by locality or setting?
No. The CLFS uses one national amount for the code across localities, without an office-versus-facility adjustment.
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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