CPT code 84295: Sodium test, serum, plasma, or whole blood2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures sodium concentration in a blood specimen to assess fluid and electrolyte balance or monitor conditions and treatments affecting sodium levels.
Medicare pays $4.81 for 84295 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
$4.81
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
- QW · CLIA-waived test
- $4.81
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 84295 covers
This clinical chemistry test measures sodium concentration in serum, plasma, or whole blood. It is commonly ordered to evaluate fluid and electrolyte balance, including in patients with dehydration, kidney or adrenal disorders, or changes in sodium levels during treatment. Hospital, reference, and physician-office laboratories perform and report the assay. Sodium may also be measured as part of an electrolyte or chemistry panel when that panel is ordered and performed.
Report 84295 for the individual sodium assay. CMS also lists a CLIA-waived version with modifier QW for eligible sites holding a CLIA certificate of waiver. Medicare pays the test only under the CLFS, with one national amount per code across all states and localities and no office-versus-facility payment difference. The 2026 national CLFS amount is $4.81, unchanged since 2020. The test has no separate physician fee schedule payment.
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 84295
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 84295. 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 84295 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 84295 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $4.81.
84295 on the lab fee schedule since 2020
84295 · CLFS 2026 Q4 (current)
$4.81
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.
84295 compared with similar tests
- 80051Electrolyte panelFour blood electrolytes$7.01
- 84295 reports an individual sodium assay. 80051 is for the complete electrolyte panel, which includes sodium.
- 80048Basic metabolic panelTotal calcium$8.46
- 84295 reports sodium alone; 80048 reports the complete basic metabolic panel, including sodium and other chemistry tests.
- 80053Metabolic panelFourteen blood chemistry tests$10.56
- Use 84295 for an individual sodium assay. 80053 reports a comprehensive metabolic panel that includes sodium.
- 82435Chloride testBlood specimen$4.60
- 84295 measures sodium, while 82435 measures chloride. They are separate electrolyte assays.
84295 billing questions
When should 84295 be reported instead of an electrolyte panel?
Report 84295 when the individual sodium assay is performed and reported. When a complete electrolyte panel is performed, report the applicable panel code rather than separately reporting its sodium component.
Which blood specimens are included?
The assay may use serum, plasma, or whole blood. Report the specimen actually tested.
When is modifier QW appropriate?
Use QW for the CLIA-waived version when the testing site holds a CLIA certificate of waiver and performs the waived test.
How does Medicare pay for 84295?
Medicare pays 84295 under the CLFS at one national amount per code, regardless of locality or office versus facility setting. The test has no separate physician fee schedule payment.
Is a physician interpretation separately payable with 84295?
The code is paid only under the CLFS; it has no separate physician fee schedule payment.
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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