CPT code 82681: Free estradiol, direct measurement2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Directly measures free estradiol when a clinician needs the unbound hormone result rather than a total estradiol measurement.
Medicare pays $27.94 for 82681 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
$27.94
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2021
- 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 82681 covers
82681 identifies laboratory measurement of free estradiol, the unbound fraction of the hormone, by a direct method. Equilibrium dialysis is an example of a direct measurement approach. A clinical laboratory reports this service when the test performed measures free estradiol; the code distinguishes that result from total estradiol and from assays reporting estrogens more broadly. Code selection follows the analyte and measurement performed, not simply the fact that an estradiol-related test was ordered.
Medicare pays 82681 under the CLFS at one national amount across all states and localities, without an office or facility payment difference. The 2026 national CLFS amount is $27.94, unchanged from 2021 through 2026. The test is paid only through the CLFS and is excluded from the physician fee schedule.
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 82681
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 82681. 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 82681 with status X (excluded by statute), so the test itself is paid only from the CLFS.
82681 on the lab fee schedule since 2021
82681 · CLFS 2026 Q4 (current)
$27.94
Unchanged since Jan 1, 2021
24 quarterly CLFS releases on file, first CLFS 2021 Q1. A code missing from a quarter wasn’t on that release.
82681 compared with similar tests
- 82670EstradiolTotal estradiol$27.94
- Use 82670 for total estradiol and 82681 for direct measurement of free estradiol. The assay performed determines the choice.
- 82671Estrogen testFractionated$32.30
- 82671 represents an assay of estrogens, while 82681 is specific to free estradiol measured directly.
- 82672Estrogen testTotal estrogen$21.70
- 82672 is an estrogen assay; 82681 identifies direct measurement of the free estradiol fraction.
82681 billing questions
How does 82681 differ from 82670?
82681 is for direct measurement of free estradiol; 82670 is for total estradiol. Select the code that matches the assay performed and result reported.
Can 82681 be used for a general estrogen assay?
No. Report 82681 for free estradiol specifically. A broader estrogen assay is represented by a different code, such as 82671 or 82672.
Does 82681 include a physician interpretation?
Medicare pays 82681 through the CLFS, and the test is excluded from the physician fee schedule.
Does Medicare pay a different amount by locality or setting?
No. The CLFS amount is national and applies across localities, with no office-versus-facility difference.
Should 82681 be reported when only total estradiol was measured?
No. Use 82681 only when the laboratory directly measures free estradiol; use 82670 when the assay measures total estradiol.
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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