CPT code 84460: ALT test, SGPT enzyme level2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures alanine aminotransferase activity in blood to assess liver-cell injury, often as part of liver chemistry evaluation or medication monitoring.
Medicare pays $5.30 for 84460 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
$5.30
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
- $5.30
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 84460 covers
The ALT test measures alanine aminotransferase, also called SGPT, an enzyme found mainly in liver cells. It is typically performed by a clinical laboratory on a blood specimen and may be ordered when evaluating suspected liver injury, following liver enzyme levels over time, or monitoring a patient taking medication that can affect the liver. ALT is commonly evaluated alongside AST and other liver-related chemistry tests; an elevated result is interpreted with the clinical picture and other findings.
Report 84460 for the individual ALT assay. When ALT is performed as part of a hepatic function panel or comprehensive metabolic panel, it is included in that panel rather than separately reported as an additional test. CMS also lists a CLIA-waived version identified with modifier QW for sites holding a CLIA certificate of waiver. Medicare pays the test through the CLFS, with one national amount across localities and no office-versus-facility difference; the 2026 amount is $5.30, unchanged since 2020.
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 84460
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 84460. 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 84460 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 84460 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $5.30.
84460 on the lab fee schedule since 2020
84460 · CLFS 2026 Q4 (current)
$5.30
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.
84460 compared with similar tests
- 84450ASTAspartate aminotransferase$5.18
- 84450 measures AST (SGOT), while 84460 measures ALT (SGPT). The two are distinct assays and may be ordered together.
- 80076Liver panelSeven liver chemistry tests$8.17
- 80076 is a hepatic function panel that includes ALT along with other liver-related tests. Use 84460 when the individual ALT assay is performed rather than the panel.
- 80053Metabolic panelFourteen blood chemistry tests$10.56
- 80053 is a comprehensive metabolic panel that includes ALT among its chemistry tests. Use 84460 for the individual ALT assay, not as an additional charge for ALT included in the panel.
84460 billing questions
How is ALT different from AST?
ALT (SGPT) and AST (SGOT) are separate enzyme assays. Report 84460 for ALT and 84450 for AST when both are performed.
Can 84460 be reported with a hepatic function panel?
ALT is included in the hepatic function panel, 80076. When the panel is performed, report the panel rather than separately billing 84460 for its included ALT test.
Is ALT included in a comprehensive metabolic panel?
Yes. ALT is one of the tests in comprehensive metabolic panel 80053, so report the panel when that panel is performed rather than billing 84460 separately for the included assay.
When is modifier QW appropriate?
CMS lists a CLIA-waived version of the test with modifier QW. Use QW for the waived test performed by a site holding a CLIA certificate of waiver.
How does Medicare pay for 84460?
Medicare pays 84460 under the CLFS at one national amount, with no locality or office-versus-facility adjustment.
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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