CPT code 84075: Alkaline phosphatase2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures alkaline phosphatase activity in a specimen, commonly to evaluate or monitor liver and bone conditions when a standalone result is needed.
Medicare pays $5.18 for 84075 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
$5.18
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
- $5.18
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 84075 covers
This assay measures alkaline phosphatase, an enzyme associated with the liver and bone, in a patient specimen. Clinicians commonly order it when evaluating abnormal liver tests, possible bile duct problems, or disorders affecting bone, and to monitor relevant conditions. Clinical laboratories perform the assay; some physician-office laboratories may perform the CLIA-waived version when they hold a certificate of waiver.
Report one unit for the assay performed. When the test is performed under the CLIA waiver, append modifier QW. If alkaline phosphatase is included in a comprehensive metabolic panel, report the panel rather than separately reporting its component. Medicare pays this test through the CLFS, not the physician fee schedule. The 2026 national CLFS amount is $5.18, unchanged from 2020 through 2025; payment is uniform across localities and care settings.
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 84075
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 84075. 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 84075 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 84075 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $5.18.
84075 on the lab fee schedule since 2020
84075 · CLFS 2026 Q4 (current)
$5.18
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.
84075 compared with similar tests
- 84078Alkaline phosphataseHeat-stable fraction$8.26
- Use 84075 for a general alkaline phosphatase assay; 84078 identifies the heat-stable form.
- 84080Alkaline phosphataseIsoenzyme fractions$14.78
- Use 84075 for a general enzyme measurement. Choose 84080 when the test analyzes alkaline phosphatase isoenzymes.
- 80053Metabolic panelFourteen blood chemistry tests$10.56
- Report 80053 when the comprehensive metabolic panel is performed; alkaline phosphatase is one of its included tests. Report 84075 for a standalone assay.
84075 billing questions
When should I report 84075 instead of 84078?
Report 84075 for a general alkaline phosphatase assay. Code 84078 is for the heat-stable form.
How does 84075 differ from 84080?
84075 measures alkaline phosphatase generally; 84080 is used for alkaline phosphatase isoenzymes.
Can I report 84075 with a comprehensive metabolic panel?
Alkaline phosphatase is included in the comprehensive metabolic panel, code 80053. When that panel is performed, report the panel rather than separately reporting this component.
When is modifier QW appropriate?
Append QW when reporting the CLIA-waived version of the test at a site holding a CLIA certificate of waiver.
Does Medicare pay 84075 under the physician fee schedule?
No. Medicare pays the test through the CLFS, with one national amount across localities and 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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