CPT code 83704: Lipoprotein particles, particle-number quantitation2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Quantifies lipoprotein particle numbers in blood, often to assess atherogenic particle burden when evaluating cardiovascular risk.
Medicare pays $34.19 for 83704 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
$34.19
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 83704 covers
This blood test quantifies the number of lipoprotein particles and may include particle subclasses in the analysis. Nuclear magnetic resonance spectroscopy is one method used to measure the particles. Clinicians may order particle-number information as part of a lipid-related cardiovascular risk assessment. A clinical laboratory performs and reports the analysis.
Report 83704 for particle-number quantitation; subclasses included in that analysis are not separate services under the code. Medicare pays the test only through the CLFS, at one national amount applicable in every state and locality, without geographic or office-versus-facility adjustment. The 2026 national amount is $34.19, unchanged since 2020. The code 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 83704
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 83704. 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 83704 with status X (excluded by statute), so the test itself is paid only from the CLFS.
83704 on the lab fee schedule since 2020
83704 · CLFS 2026 Q4 (current)
$34.19
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.
83704 compared with similar tests
- 83700Lipoprotein testElectrophoretic separation$11.26
- 83700 reports lipoprotein analysis by electrophoresis. Choose 83704 when the service quantifies particle numbers rather than providing an electrophoretic fraction pattern.
- 83701Lipoprotein profileHigh-resolution fractions$33.86
- 83701 describes high-resolution lipoprotein fractionation and quantitation. 83704 is for quantifying particle numbers, including subclasses when performed.
- 83721LDL cholesterolDirect LDL measurement$10.50
- 83721 measures LDL cholesterol directly; it does not quantify lipoprotein particle numbers.
- 83718HDL cholesterolDirect measurement$8.19
- 83718 measures HDL-related cholesterol, whereas 83704 quantifies lipoprotein particle numbers.
83704 billing questions
When is 83704 preferable to a routine lipid measurement?
Use 83704 when the laboratory analysis quantifies lipoprotein particle numbers. Tests that measure cholesterol in a particular lipoprotein, such as LDL or HDL, report a different result.
Are particle subclasses reported separately?
No. Subclasses, when performed as part of the particle-number analysis, are included in 83704.
How many units should be reported?
Report the particle-number analysis once; included particle subclasses do not create additional units.
Does modifier 26 apply?
Medicare pays 83704 only through the CLFS, not through the physician fee schedule.
Can 83704 be reported with a standard lipid panel?
It may be reported with a lipid panel when both the cholesterol measurements and particle-number analysis are performed and documented.
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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