CPT code 86140: CRP test, standard CRP assay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures C-reactive protein as a nonspecific marker of infection or inflammation, supporting evaluation and monitoring of inflammatory conditions.
Medicare pays $5.18 for 86140 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
$5.18
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 86140 covers
Code 86140 reports a laboratory measurement of C-reactive protein (CRP), an acute-phase protein that can rise with inflammation and infection. The test is commonly performed on serum or plasma in hospital, reference, and physician-office laboratories. Clinicians use the result with symptoms and other findings when evaluating suspected infection or inflammation, or monitoring an inflammatory condition. The result is not specific to a single disease or cause.
Report one unit for each CRP test performed. Use 86140 for a standard CRP measurement; code 86141 identifies the high-sensitivity assay. Medicare pays 86140 through the CLFS at one national amount, with no locality or office-versus-facility adjustment. The 2026 national CLFS amount is $5.18, unchanged since 2020. The test is excluded from the physician fee schedule by statute.
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 86140
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 86140. 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 86140 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86140 on the lab fee schedule since 2020
86140 · CLFS 2026 Q4 (current)
$5.18
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.
86140 compared with similar tests
- 86141High-sensitivity CRPHigh-sensitivity measurement$12.95
- 86141 is the high-sensitivity CRP assay, suited to measuring lower concentrations. Use 86140 for standard CRP testing in infection or inflammation evaluation.
- 85652Sedimentation rateAutomated method$2.70
- 85652 measures erythrocyte sedimentation rate, a separate inflammatory marker. Code 86140 reports a CRP measurement; the tests may be ordered together.
86140 billing questions
When should 86140 be used instead of 86141?
Use 86140 for a standard CRP measurement used in evaluating infection or inflammation. Code 86141 identifies the high-sensitivity CRP assay, which measures lower CRP concentrations.
How many units are reported?
Report one unit for each CRP test performed.
Can 86140 be billed with an erythrocyte sedimentation rate?
Yes. CRP and erythrocyte sedimentation rate (85652) are distinct inflammatory markers and may both be ordered as part of an evaluation.
Does Medicare pay 86140 under the physician fee schedule?
No. Medicare pays this test through the CLFS at one national amount that applies across localities and care settings.
What should the order or record support?
The documentation should identify the clinical reason for measuring CRP, such as evaluating or monitoring suspected infection or inflammation.
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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