CPT code 84153: Total PSA2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures total prostate-specific antigen in a blood specimen, commonly for evaluating prostate-related findings or monitoring prostate cancer.
Medicare pays $18.39 for 84153 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
$18.39
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 84153 covers
This laboratory assay measures total prostate-specific antigen (PSA) in a blood specimen, typically serum. Primary care clinicians and urologists may order it when evaluating prostate-related symptoms or findings and when monitoring a patient with prostate cancer. The result measures total PSA rather than separating the free and protein-bound fractions. A laboratory reports the assay result to the ordering clinician for interpretation alongside the patient’s clinical context and other findings.
Report 84153 for the total PSA assay, generally as one unit for one specimen tested. When a separate free PSA assay is performed, it is reported separately with 84154. Medicare pays 84153 from the Clinical Laboratory Fee Schedule (CLFS), not the physician fee schedule. The 2026 national CLFS amount is $18.39 and has remained unchanged from 2020 through 2026. The same amount applies across states and localities, without a geographic adjustment or office-versus-facility difference.
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 84153
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 84153. 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 84153 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84153 on the lab fee schedule since 2020
84153 · CLFS 2026 Q4 (current)
$18.39
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.
84153 compared with similar tests
84153 billing questions
When should 84153 be reported instead of 84154?
Report 84153 for measurement of total PSA. Report 84154 when the laboratory performs a separate free PSA assay.
How does 84153 differ from 84152?
84153 measures total PSA, while 84152 measures complexed PSA. Select the code that matches the fraction measured by the assay.
How many units are typically reported?
Typically, report one unit for one total PSA assay on a specimen. The code represents the total PSA measurement, not separate units for PSA fractions.
Is a physician interpretation separately paid with 84153?
Medicare pays 84153 through the CLFS. The code is excluded from the physician fee schedule, so it does not carry a separately payable physician interpretation component under that schedule.
Does Medicare use a different 84153 amount by locality or setting?
No. Medicare uses one national CLFS amount for the code across localities, without an 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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