CPT code 83690: Lipase2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures lipase in a patient specimen, commonly to evaluate suspected acute pancreatitis or abdominal pain when pancreatic disease is considered.
Medicare pays $6.89 for 83690 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
$6.89
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 83690 covers
83690 reports a laboratory measurement of lipase, an enzyme involved in fat digestion. Clinicians order it when evaluating suspected acute pancreatitis, including patients with upper abdominal pain, and in other assessments of pancreatic disease. Clinical laboratories commonly perform the assay on serum or plasma for hospital and outpatient clinicians. An elevated result can support the evaluation, but clinicians interpret it with the patient's presentation.
Report 83690 for the lipase assay performed. The code reports the laboratory test, not a result value or abnormal finding. Medicare pays the test through the CLFS at one national amount across states and localities, without an office-versus-facility difference. The 2026 national CLFS amount is $6.89, unchanged since 2020. Payment is through the CLFS rather than 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 83690
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 83690. 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 83690 with status X (excluded by statute), so the test itself is paid only from the CLFS.
83690 on the lab fee schedule since 2020
83690 · CLFS 2026 Q4 (current)
$6.89
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.
83690 compared with similar tests
- 82150AmylaseEnzyme activity$6.48
- Code 82150 measures amylase, a different enzyme that may be tested in the same pancreatitis workup. Use 83690 when the laboratory assay is for lipase.
- 80053Metabolic panelFourteen blood chemistry tests$10.56
- Code 80053 reports a comprehensive metabolic panel, not a lipase assay. Report 83690 separately when lipase is measured.
83690 billing questions
When should 83690 be used instead of amylase code 82150?
Use 83690 when the assay measures lipase. Code 82150 describes an amylase assay; clinicians may order both tests when evaluating suspected pancreatitis.
How many units should be reported?
Report 83690 for the lipase assay, not once for each result value or abnormal finding.
What does 83690 report?
It reports a laboratory measurement of lipase. Medicare pays the test through the CLFS.
How does Medicare pay 83690?
Medicare pays one national CLFS amount per code across states and localities, 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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