CPT code 82465: Cholesterol, total, serum or whole blood2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures total cholesterol in serum or whole blood for lipid evaluation, cardiovascular risk assessment, or monitoring of lipid-lowering treatment.
Medicare pays $4.35 for 82465 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
$4.35
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
- $4.35
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 82465 covers
This assay measures total cholesterol in serum or whole blood. It may be ordered as a standalone measurement to evaluate lipid levels, assess cardiovascular risk, or monitor lipid-lowering treatment. It reports total cholesterol rather than separate HDL, LDL, or triglyceride results. Clinical laboratories perform the assay, and sites holding a CLIA certificate of waiver may perform its waived version. Use modifier QW when reporting the waived version.
Report 82465 for the total-cholesterol assay performed; when the broader lipid panel is performed, report the panel rather than separately billing its total-cholesterol component. Medicare pays 82465 under the CLFS, with one national amount applying in every state and locality and no office-versus-facility difference. The 2026 national CLFS amount is $4.35, unchanged since 2020. The test is paid through the CLFS.
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 82465
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 82465. 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 82465 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 82465 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $4.35.
82465 on the lab fee schedule since 2020
82465 · CLFS 2026 Q4 (current)
$4.35
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.
82465 compared with similar tests
- 80061Lipid panelCholesterol and triglycerides$13.39
- 82465 reports total cholesterol alone. Code 80061 represents a lipid panel when the broader panel testing is performed.
- 83718HDL cholesterolDirect measurement$8.19
- 83718 measures HDL cholesterol specifically; 82465 measures total cholesterol.
- 84478TriglyceridesIndividual measurement$5.74
- 84478 measures triglycerides, not total cholesterol. Select 82465 when the assay performed measures total cholesterol.
82465 billing questions
When should I report 82465 instead of a lipid panel?
Report 82465 for a separately performed total-cholesterol assay. When the broader lipid panel is performed, report 80061 rather than separately billing the panel's total-cholesterol component.
Does 82465 measure HDL or triglycerides?
No. It reports total cholesterol; HDL cholesterol and triglycerides are distinct tests reported with codes such as 83718 and 84478.
When is modifier QW appropriate?
Use QW for the CLIA-waived version when the performing site holds a CLIA certificate of waiver.
Can 82465 be reported with 80061 for the same panel?
Do not separately report 82465 as the total-cholesterol component when the broader lipid panel is performed and reported with 80061.
How does Medicare pay for 82465?
Medicare pays 82465 under the CLFS at one national amount that applies in every locality, with no office-versus-facility difference.
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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