CPT code 84233: Estrogen receptor, tumor receptor analysis2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures estrogen receptors in tumor tissue, commonly in breast cancer, to characterize receptor status relevant to treatment planning.
Medicare pays $87.88 for 84233 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
$87.88
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 84233 covers
This assay evaluates estrogen receptors in tumor tissue; it does not measure circulating estrogen. It is most commonly associated with breast cancer tissue testing, where receptor status helps characterize the tumor and inform treatment planning. A pathology or clinical laboratory performs and reports the analysis on submitted tissue.
Report 84233 for the estrogen receptor assay itself. Choose the code based on the work performed; quantitative or semiquantitative immunohistochemistry has separate coding options. For immunohistochemical analysis, 88360 or 88361 may be selected according to the manual or automated method. Medicare pays this test only through the CLFS, at one national amount with no locality or office-versus-facility adjustment. The 2026 national CLFS amount is $87.88, unchanged since 2020. The code is excluded from 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 84233
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 84233. 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 84233 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84233 on the lab fee schedule since 2020
84233 · CLFS 2026 Q4 (current)
$87.88
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.
84233 compared with similar tests
- 84234Progesterone receptorTumor tissue analysis$64.88
- Use 84233 for estrogen receptor analysis and 84234 for progesterone receptor analysis.
- 84238Receptor assaySpecified nonendocrine receptor$36.57
- 84238 addresses a nonendocrine receptor; 84233 is specific to estrogen receptor analysis.
- 82670EstradiolTotal estradiol$27.94
- 82670 measures estradiol concentration, whereas 84233 evaluates estrogen receptors in tumor tissue.
- 88360Tumor IHC scoringManual quantitative, per antibody$106.97–$163.58
- 88360 describes quantitative or semiquantitative immunohistochemistry using a manual method; 84233 identifies an estrogen receptor assay.
84233 billing questions
Does 84233 measure estrogen in blood?
No. It evaluates estrogen receptors in tumor tissue; it is not a test of circulating estrogen or estradiol concentration.
How does 84233 differ from 84234?
84233 is for estrogen receptor analysis, while 84234 is for progesterone receptor analysis. Select the code for the receptor tested.
When should an immunohistochemistry code be considered?
When the work is quantitative or semiquantitative immunohistochemistry, compare 84233 with the applicable IHC code, such as 88360 or 88361. Select based on the method and work performed.
How does Medicare pay 84233?
Medicare pays it through the CLFS only. The national amount is the same across localities, with no office or 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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