CPT code 83695: Lipoprotein(a), measured lipoprotein(a) level2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures lipoprotein(a), a cardiovascular risk-related particle, when clinicians assess atherosclerotic cardiovascular disease risk.
Medicare pays $14.32 for 83695 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
$14.32
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 83695 covers
This assay measures the level of lipoprotein(a), a cholesterol-carrying particle associated with atherosclerotic cardiovascular disease risk. Clinicians may order it when assessing cardiovascular risk, including for patients with a personal or family history that raises concern for premature cardiovascular disease. The result adds information distinct from the cholesterol values reported in a standard lipid panel. Testing is generally performed by a clinical laboratory on a blood specimen.
Report 83695 for the lipoprotein(a) assay performed. Medicare pays the test only under the Clinical Laboratory Fee Schedule. The 2026 national CLFS amount is $14.32, unchanged from 2020 through 2026; the same amount applies across localities, without a geographic or office/facility adjustment. The physician fee schedule excludes the test.
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 83695
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 83695. 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 83695 with status X (excluded by statute), so the test itself is paid only from the CLFS.
83695 on the lab fee schedule since 2020
83695 · CLFS 2026 Q4 (current)
$14.32
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.
83695 compared with similar tests
- 80061Lipid panelCholesterol and triglycerides$13.39
- Choose 80061 for a standard lipid panel. Use 83695 when the test performed measures lipoprotein(a); the panel does not report that analyte.
- 83698Lp-PLA2 assayEnzyme level$46.31
- 83698 measures lipoprotein-associated phospholipase A2, not lipoprotein(a). Select the code matching the analyte measured.
- 83704Lipoprotein particlesParticle-number quantitation$34.19
- 83704 represents lipoprotein analysis by electrophoretic separation and quantitation. 83695 is specific to the lipoprotein(a) assay.
83695 billing questions
How is 83695 different from a standard lipid panel?
83695 measures lipoprotein(a) specifically. A standard lipid panel reports common lipid measurements and does not provide a lipoprotein(a) result.
Is 83695 the same test as lipoprotein-associated phospholipase A2?
No. 83695 measures lipoprotein(a); 83698 measures lipoprotein-associated phospholipase A2, a different analyte.
What does the result represent?
It reports the measured lipoprotein(a) level, not the common lipid measurements reported in a standard lipid panel.
Can modifier 26 be reported for a physician interpretation?
Medicare pays 83695 only under the CLFS; the physician fee schedule excludes the test.
How does Medicare pay for this test?
Medicare pays 83695 under the CLFS at one national amount that applies across localities and in office and facility settings.
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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