CPT code 84378: Sugar assay, single, quantitative2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Quantitative carbohydrate analysis measures one sugar in a specimen when a clinician needs its concentration rather than a qualitative result or multi-sugar analysis.
Medicare pays $11.53 for 84378 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
$11.53
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 84378 covers
This laboratory test quantitatively analyzes one carbohydrate, such as a mono-, di-, or oligosaccharide, in a submitted specimen. It is selected when the clinical question calls for the amount of one specific sugar, rather than simply whether a sugar is present or measuring several sugars together. A clinical laboratory performs the analysis and reports the quantitative result to the ordering clinician.
Report the service for each specimen analyzed for one sugar. Use a qualitative code when the result is limited to presence or absence, and a multiple-sugar code when more than one sugar is analyzed. Medicare pays this test only through the CLFS. The 2026 national CLFS amount is $11.53, unchanged since 2020; the same amount applies across states and localities, with no office-versus-facility difference. The test 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 84378
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 84378. 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 84378 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84378 on the lab fee schedule since 2020
84378 · CLFS 2026 Q4 (current)
$11.53
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.
84378 compared with similar tests
- 84376Sugar analysisSingle qualitative$5.50
- Choose 84378 for a quantitative result for one sugar. Code 84376 is for qualitative analysis of one sugar.
- 84377Sugar analysisMultiple sugars, qualitative$5.50
- Code 84377 is for qualitative analysis of multiple sugars; 84378 is quantitative and covers one sugar.
- 84379Sugar analysisMultiple, quantitative$11.53
- Both codes describe quantitative sugar analysis, but 84379 covers multiple sugars while 84378 covers one.
- 84375Sugar chromatographyTLC or paper method$39.00
- Code 84375 identifies chromatogram sugar analysis. Code 84378 identifies quantitative analysis of a single sugar.
84378 billing questions
When should this code be used instead of a qualitative sugar code?
Use this code when the laboratory reports a quantitative result for one sugar. A result limited to whether sugar is present or absent is qualitative.
How does this code differ from the multiple-sugar quantitative code?
This code represents quantitative analysis of one sugar in a specimen. Use the multiple-sugar quantitative code when the analysis covers multiple sugars.
How many units should be reported?
The code is reported for each specimen analyzed. It represents one sugar analyzed quantitatively per specimen.
Does Medicare pay this test under the physician fee schedule?
No. Medicare pays it through the CLFS; the test 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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