CPT code 84135: Pregnanediol, reproductive hormone level2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A laboratory assay of pregnanediol, a reproductive-hormone metabolite, is reported when testing specifically measures this analyte.
Medicare pays $21.27 for 84135 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
$21.27
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 7 sections
What 84135 covers
Code 84135 identifies laboratory measurement of pregnanediol, a progesterone-related metabolite. It is distinct from assays for progesterone itself and other steroid analytes such as pregnanetriol. Report this code when the laboratory test measures pregnanediol. The result is the pregnanediol level; 84144 identifies progesterone testing, while 84138 identifies pregnanetriol testing.
Medicare pays 84135 under the Clinical Laboratory Fee Schedule, which provides one national amount across localities, without geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $21.27, unchanged from 2020 through 2026. The code is paid through the CLFS only, rather than the physician fee schedule. Report the assay code for the analyte measured; a progesterone or pregnanetriol assay is a separate 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 84135
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 84135. 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 84135 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84135 on the lab fee schedule since 2020
84135 · CLFS 2026 Q4 (current)
$21.27
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.
84135 compared with similar tests
- 84138PregnanetriolUrinary steroid metabolite$21.05
- Use 84135 for pregnanediol and 84138 for pregnanetriol; the codes identify different steroid metabolites.
- 84140PregnenoloneReproductive hormone assay$20.67
- 84140 measures pregnenolone, not pregnanediol. Select the code for the analyte measured.
- 84144Progesterone testSerum concentration$20.86
- 84144 identifies progesterone testing; 84135 identifies testing for the related metabolite pregnanediol.
84135 billing questions
What analyte does 84135 identify?
It identifies laboratory measurement of pregnanediol, a progesterone-related metabolite.
How does 84135 differ from 84144?
84135 is for pregnanediol; 84144 is for progesterone itself.
How does 84135 differ from 84138?
84135 measures pregnanediol, while 84138 measures pregnanetriol.
Which Medicare payment schedule applies?
Medicare pays 84135 through the CLFS. It is paid through the CLFS only.
Does the CLFS amount vary by locality or setting?
No. One national amount applies across localities, with no geographic or office-versus-facility adjustment.
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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