CPT code 84234: Progesterone receptor, tumor tissue analysis2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Progesterone receptor analysis evaluates receptor status in tissue, commonly as part of pathology assessment of a breast tumor.
Medicare pays $64.88 for 84234 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
$64.88
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 84234 covers
This test evaluates progesterone receptors in tissue rather than measuring progesterone circulating in blood. Pathology laboratories commonly report it as part of tumor characterization, especially in breast cancer assessment. The result describes the tumor’s progesterone receptor status and is distinct from a serum or plasma progesterone concentration test.
Report 84234 for progesterone receptor analysis; 84233 identifies a different receptor target. Medicare pays the test through the Clinical Laboratory Fee Schedule (CLFS), not the physician fee schedule. The 2026 national CLFS amount is $64.88 and has been unchanged since 2020. One amount applies nationwide, with no locality, geographic, office, or facility adjustment.
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 84234
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 84234. 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 84234 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84234 on the lab fee schedule since 2020
84234 · CLFS 2026 Q4 (current)
$64.88
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.
84234 compared with similar tests
- 84233Estrogen receptorTumor receptor analysis$87.88
- Use 84233 for the other receptor target and 84234 for progesterone receptor analysis. The target documented by the laboratory distinguishes the codes.
- 84235Hormone receptor assayOther than estrogen or progesterone$71.23
- 84235 identifies an endocrine hormone assay; 84234 identifies progesterone receptor analysis.
- 84238Receptor assaySpecified nonendocrine receptor$36.57
- 84238 is for a nonendocrine receptor assay; 84234 is specifically for progesterone receptor analysis.
- 84144Progesterone testSerum concentration$20.86
- 84144 measures progesterone concentration, while 84234 evaluates progesterone receptors in tissue. Select according to the analyte and test performed.
84234 billing questions
Is 84234 a blood progesterone test?
No. It represents progesterone receptor analysis in tissue. A test measuring circulating progesterone is a different service.
How does 84234 differ from 84233?
84234 identifies progesterone receptor analysis, while 84233 identifies a different receptor target. Match the code to the target tested.
Can both 84234 and 84233 be reported?
They identify different receptor targets. The documented tests determine which code or codes describe the services performed.
Does Medicare pay 84234 under the physician fee schedule?
No. Medicare pays this test through the CLFS; it is excluded from the physician fee schedule.
Does the CLFS payment vary by location or setting?
No. One national CLFS amount applies across states and localities, without an 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
Fee sheets · Coming soon
Put 84234 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist