CPT code 85018: Hemoglobin, hemoglobin only2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures hemoglobin concentration in blood and is reported when a clinician orders hemoglobin as a standalone test rather than a complete blood count.
Medicare pays $2.37 for 85018 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
$2.37
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
- $2.37
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 85018 covers
85018 measures hemoglobin, the oxygen-carrying protein in red blood cells, in a blood specimen. Clinicians use the result to assess anemia, blood loss, or other conditions affecting oxygen-carrying capacity. It is reported when hemoglobin is the measured service rather than as one component of a broader blood count. Laboratories and point-of-care testing sites perform the test. A CLIA-waived version may be performed at sites holding a CLIA certificate of waiver; report that version with modifier QW.
When a complete blood count is performed, report the applicable CBC code rather than separately reporting its hemoglobin component. Medicare pays 85018 through the CLFS at one national amount across localities, with no geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $2.37, unchanged since 2020. The physician fee schedule excludes the test, so 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 85018
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 85018. 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 85018 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 85018 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $2.37.
85018 on the lab fee schedule since 2020
85018 · CLFS 2026 Q4 (current)
$2.37
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.
85018 compared with similar tests
- 85025Complete CBCAutomated differential$7.77
- 85018 is a standalone hemoglobin measurement. 85025 represents a broader complete blood count with automated differential and includes hemoglobin.
- 85027Complete CBCWithout automated differential$6.47
- 85027 is an automated complete blood count without differential, including hemoglobin; use 85018 when only hemoglobin is measured.
- 85014Hematocrit$2.37
- 85014 reports hematocrit, the proportion of blood volume occupied by red cells. 85018 reports hemoglobin concentration.
- 85013MicrohematocritSpun method$7.00
- 85013 reports a spun microhematocrit result. It is a hematocrit test, not a hemoglobin measurement.
85018 billing questions
When should 85018 be reported instead of a CBC?
Report 85018 when the ordered and performed test is a standalone hemoglobin measurement. Use the applicable CBC code when a complete blood count is performed; hemoglobin is included in that broader test.
Can 85018 be billed separately with a CBC?
Do not separately report the hemoglobin measurement when it is part of the CBC performed on the same specimen. Report the CBC that represents the service performed.
When is modifier QW used?
Use QW for the CLIA-waived version when the testing site holds a CLIA certificate of waiver and performs the waived test.
Does Medicare pay 85018 under the physician fee schedule?
No. Medicare pays 85018 through the CLFS, using one national amount across localities and 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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