CPT code 84154: Free PSA, unbound PSA fraction2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures unbound prostate-specific antigen in serum, commonly alongside total PSA to help assess prostate cancer risk after an elevated result.
Medicare pays $18.39 for 84154 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 84154 covers
This laboratory assay measures the unbound fraction of prostate-specific antigen (PSA) in serum. Clinicians, including primary care providers and urologists, may order it during evaluation of an elevated total PSA, particularly when additional information could help assess the likelihood of prostate cancer versus benign prostate conditions. The free PSA result is often considered in relation to total PSA; it supports risk assessment and is not a stand-alone cancer diagnosis.
Report this code for the free PSA assay performed. When both free and total PSA are measured, report each assay; the free-to-total relationship is derived from those results. Medicare pays the test only through the CLFS, with one national amount across localities and no office or facility payment difference. The 2026 national CLFS amount is $18.39, unchanged since 2020. There is no separate physician-fee-schedule payment for this 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 84154
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 84154. 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 84154 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84154 on the lab fee schedule since 2020
84154 · 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.
84154 compared with similar tests
84154 billing questions
When should 84154 be reported instead of total PSA?
Report 84154 for the free PSA fraction, not for a total PSA measurement. Total PSA is reported with 84153.
Can free and total PSA be reported together?
Yes, when both assays are performed. The free-to-total relationship is calculated from the free and total PSA results.
Is complexed PSA interchangeable with free PSA?
No. Code 84152 measures complexed PSA, while 84154 measures the unbound fraction; select the code that matches the assay performed.
Does Medicare pay a separate physician interpretation for 84154?
Medicare pays 84154 through the CLFS only. The code has no separate physician-fee-schedule payment.
Does Medicare use a different CLFS amount by locality or setting?
No. Medicare uses one national CLFS amount for this code, without a locality 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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