CPT code 83719: VLDL cholesterol, direct measurement2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports a direct measurement of blood VLDL cholesterol for evaluation of lipid abnormalities alongside other lipid results and clinical findings.
Medicare pays $12.75 for 83719 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
$12.75
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 83719 covers
This assay measures the cholesterol carried in very-low-density lipoproteins (VLDL) in a blood specimen. It may be ordered during evaluation of abnormal lipid results or as part of a more detailed assessment of lipoproteins. Clinical laboratories and physician office laboratories perform or report the assay; the result is interpreted with the patient’s other lipid measurements and clinical picture.
Report 83719 for the VLDL cholesterol measurement, rather than for HDL cholesterol, LDL cholesterol, or lipoprotein particle quantification. The 2026 national CLFS amount is $12.75, unchanged from 2020 through 2025. Medicare pays one amount per code nationwide, without geographic or office-versus-facility adjustment. The service is paid 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 83719
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 83719. 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 83719 with status X (excluded by statute), so the test itself is paid only from the CLFS.
83719 on the lab fee schedule since 2020
83719 · CLFS 2026 Q4 (current)
$12.75
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.
83719 compared with similar tests
- 83718HDL cholesterolDirect measurement$8.19
- 83718 is for HDL cholesterol. Choose 83719 when the measured fraction is VLDL.
- 83721LDL cholesterolDirect LDL measurement$10.50
- 83721 is for direct LDL cholesterol measurement; 83719 is for VLDL cholesterol.
- 83704Lipoprotein particlesParticle-number quantitation$34.19
- 83704 concerns lipoprotein particle quantification. It does not report the VLDL cholesterol measurement represented by 83719.
83719 billing questions
When should 83719 be used instead of 83718?
Use 83719 for VLDL cholesterol. Code 83718 is for HDL cholesterol, a different lipoprotein fraction.
How does 83719 differ from 83721?
83719 measures VLDL cholesterol; 83721 measures LDL cholesterol directly. Select the code for the fraction measured.
Is 83719 a particle-count test?
No. It reports VLDL cholesterol, not lipoprotein particle quantification such as the service represented by 83704.
What does Medicare pay for 83719?
Medicare pays the test under the CLFS. The national amount applies across localities and settings, with no office-versus-facility difference.
What result supports reporting 83719?
The laboratory record should support a VLDL cholesterol measurement. A result for HDL, LDL, or particle quantity alone does not describe this assay.
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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