CPT code 83655: Lead test, blood lead level2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures lead in blood for screening, evaluation of suspected exposure, or monitoring of a patient with known lead exposure.
Medicare pays $12.11 for 83655 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
$12.11
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
- $12.11
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 83655 covers
This assay measures the lead level in a blood specimen. It is commonly ordered for childhood lead screening, evaluation after possible environmental or occupational exposure, and follow-up of a known elevated level. Clinicians may order it in primary care, pediatrics, occupational health, or other settings evaluating possible lead exposure; laboratories perform and report the assay result.
Report 83655 for the lead assay, rather than for blood collection or a blood count. CMS lists a CLIA-waived version; modifier QW identifies that version when performed by a site holding a CLIA certificate of waiver. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $12.11, unchanged from 2020 through 2026; the same amount applies across localities, without an office or facility payment difference.
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 83655
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 83655. 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 83655 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 83655 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $12.11.
83655 on the lab fee schedule since 2020
83655 · CLFS 2026 Q4 (current)
$12.11
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.
83655 compared with similar tests
- 36415VenipunctureRoutine venous sample$9.34
- 36415 reports venous blood collection; 83655 reports the lead assay performed on a specimen.
- 85025Complete CBCAutomated differential$7.77
- 85025 is a complete blood count with automated differential. It does not measure lead.
- 82175Arsenic testArsenic analyte$18.97
- 82175 measures arsenic, a different analyte. Use 83655 when the test performed measures lead.
83655 billing questions
What clinical situations support reporting 83655?
Report it when a blood lead level is measured for screening, suspected exposure, or monitoring known lead exposure. The result is the lead measurement, not a blood count.
When should modifier QW be used?
Use QW for the CLIA-waived version when the test is performed by a site holding a CLIA certificate of waiver.
Does 83655 describe blood collection?
No. 83655 describes the lead assay; venous blood collection is a distinct service.
How does Medicare pay for 83655?
Medicare pays it through the CLFS at one national amount across states and localities, with no office or facility difference.
How is 83655 different from a CBC?
83655 measures lead in blood. A CBC reports blood-cell measurements and is a separate test when ordered and performed.
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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