CPT code 84160: Total protein, refractometry, any source2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports a laboratory measurement of total protein by refractometry when this method is used for a submitted specimen from any source.
Medicare pays $5.61 for 84160 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
$5.61
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 84160 covers
Code 84160 represents a laboratory measurement of total protein by refractometry. The method distinguishes this test from total-protein assays reported for a specified specimen category. A laboratory reports it when refractometry is the method used for the submitted specimen; the code permits any source. The result provides a total protein concentration, rather than separating individual protein fractions as electrophoresis does.
Medicare pays the test only under the Clinical Laboratory Fee Schedule. The 2026 national CLFS amount is $5.61 and has remained unchanged since 2020. This nationally priced amount applies across states and localities, with no geographic or office-versus-facility adjustment. Code 84160 is excluded from the physician fee schedule, so payment is through the CLFS.
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 84160
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 84160. 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 84160 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84160 on the lab fee schedule since 2020
84160 · CLFS 2026 Q4 (current)
$5.61
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.
84160 compared with similar tests
- 84155Total proteinSerum, plasma, or whole blood$3.67
- Use 84160 for total protein measured by refractometry. Code 84155 identifies a serum protein assay.
- 84156Urine proteinTotal protein$3.67
- Code 84156 identifies a urine protein assay; 84160 is for refractometric total protein from any source.
- 84157Body fluid proteinNon-serum, non-urine sources$4.00
- Code 84157 identifies a protein assay for other sources. Code 84160 specifies refractometry and applies to any source.
- 84165Protein electrophoresisSerum fractionation and quantitation$10.74
- Code 84165 reports serum protein electrophoresis, which separates protein fractions; 84160 measures total protein by refractometry.
84160 billing questions
When should a laboratory report 84160 rather than 84155?
Report 84160 when total protein is measured by refractometry. Code 84155 identifies a serum protein assay.
Does the specimen source determine whether 84160 can be used?
The code applies to refractometric total protein from any source. Document the specimen and the method used.
Is protein electrophoresis reported with 84160?
Electrophoresis separates protein fractions and is a different service from a total-protein measurement by refractometry. Report electrophoresis when that analysis is performed.
How does Medicare pay for 84160?
Medicare pays 84160 through the CLFS at one national amount that applies across localities and settings. The code is excluded from the physician fee schedule.
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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