CPT code 84145: Procalcitonin, hormone level2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Procalcitonin testing measures a hormone level used with clinical findings to assess suspected systemic bacterial infection and monitor treatment response.
Medicare pays $27.22 for 84145 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
$27.22
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 84145 covers
Procalcitonin is a hormone measured in blood; concentrations may rise with systemic bacterial infection. Clinicians use the result alongside examination findings and other tests when assessing suspected sepsis or severe infection, and may follow serial values during treatment. The assay measures a biomarker rather than identifying a pathogen. Clinical laboratories perform the assay on serum or plasma specimens ordered by treating practitioners.
Report 84145 for a procalcitonin assay. Medicare pays the test only through the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $27.22, unchanged from 2020 through 2026. One amount applies in every state and locality, with no geographic adjustment or office-versus-facility difference. The test is paid only through the CLFS, not 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 84145
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 84145. 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 84145 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84145 on the lab fee schedule since 2020
84145 · CLFS 2026 Q4 (current)
$27.22
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.
84145 compared with similar tests
- 86140CRP testStandard CRP assay$5.18
- 86140 measures C-reactive protein, a different inflammatory marker. Choose 84145 when the ordered test is specifically for procalcitonin.
- 87040Blood cultureBacterial culture$10.32
- 87040 is a blood culture that looks for organisms in blood. Code 84145 measures a biomarker and does not identify a pathogen.
- 83605Lactate testLactic acid, not LDH$11.57
- 83605 measures lactate, which can help assess tissue hypoperfusion and illness severity. It is not a procalcitonin assay.
84145 billing questions
What specimen is used for 84145?
The assay is performed on serum or plasma. The result measures the procalcitonin level in the specimen.
Does 84145 identify a bacterial pathogen?
No. It measures procalcitonin, a biomarker; a culture tests for organisms in a specimen.
How does Medicare pay for 84145?
Medicare pays 84145 through the CLFS at one national amount across localities and settings. It is paid only through the CLFS.
How does 84145 differ from a blood culture?
84145 measures a blood biomarker, while a blood culture looks for organisms in the specimen. The tests answer different clinical questions and may be ordered together.
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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