CPT code 84238: Receptor assay, specified nonendocrine receptor2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Chemical assay of a specified nonendocrine receptor, reported when laboratory testing targets that receptor rather than an endocrine hormone.
Medicare pays $36.57 for 84238 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
$36.57
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 7 sections
What 84238 covers
This code represents chemical analysis of a specified receptor that is nonendocrine. The receptor target distinguishes this assay from tests of endocrine hormones such as estrogen or progesterone. The service is a laboratory test, and the target receptor should be identified when the test is ordered and reported. An estrogen or progesterone assay is a hormone assay, not this nonendocrine receptor assay.
The test is paid through Medicare’s CLFS, with one national amount applying across states and localities, with no office-versus-facility payment difference. The 2026 national CLFS amount is $36.57, unchanged from 2020 through 2026. Medicare excludes the test from the physician fee schedule by statute, so Medicare 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 84238
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 84238. 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 84238 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84238 on the lab fee schedule since 2020
84238 · CLFS 2026 Q4 (current)
$36.57
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.
84238 compared with similar tests
- 84233Estrogen receptorTumor receptor analysis$87.88
- 84233 is an assay of estrogen. Code 84238 is for analysis of a specified nonendocrine receptor.
- 84234Progesterone receptorTumor tissue analysis$64.88
- 84234 is an assay of progesterone; 84238 is for analysis of a specified nonendocrine receptor.
- 84235Hormone receptor assayOther than estrogen or progesterone$71.23
- 84235 is an assay of an endocrine hormone. Code 84238 describes analysis of a nonendocrine receptor.
84238 billing questions
How does 84238 differ from 84233?
84233 is an assay of estrogen. Use 84238 for analysis of a specified nonendocrine receptor, rather than an estrogen assay.
How does 84238 differ from 84234?
84234 is an assay of progesterone. Code 84238 describes analysis of a specified nonendocrine receptor.
Does 84238 identify a particular receptor?
No. The receptor analyzed should be specified when the assay is ordered and reported.
How does Medicare pay for 84238?
Medicare pays for the test through the CLFS. One national amount applies across localities and office and facility settings.
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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