CPT 85046 pays $5.57 under the 2026 Q4 Medicare Clinical Laboratory Fee Schedule, the same national rate in every state.
National rate
$5.57
Same in every state
$5.57 in every state. The 2026 Q4 Medicare Clinical Laboratory Fee Schedule sets one national amount for CPT 85046; it is not adjusted by locality or by site of service.
Here is how the Medicare Clinical Laboratory Fee Schedule arrives at the CPT 85046 amount above, and what it does and doesn't cover.
Clinical lab tests are paid from the Clinical Laboratory Fee Schedule, not the Physician Fee Schedule. CMS sets one national amount per test, so 85046 pays the same in every state.
Lab rates are a flat fee per test. They are not built from RVUs or adjusted by GPCI, and the amount does not change between an office and a hospital setting.
Commercial payers set their own negotiated rates, and routinely pay above or below the Medicare amount for the same code. See how UHC, Aetna, Cigna and BCBS actually price 85046.
This page reflects the 2026 Q4 CMS Clinical Laboratory Fee Schedule, effective 2026-10-01. Want the full story behind why this data is public at all — the rules, the deadlines, the penalties? Read the price transparency law guide.
Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.