CLFS - Clinical Laboratory Fee Schedule

National payment rates for clinical laboratory services by HCPCS, including modifiers, effective dates, and code descriptions.

Select CLFS - Clinical Laboratory Fee Schedule in the Medicare dataset picker to work with this data.

Medicare does not apply geographic adjustments to the CLFS. The national Rate is the benchmark for every provider, regardless of where the lab is located — there is no wage index or locality step.

Fields

Field Name	UI Name	Description / Sample Value
Year	Year	Effective fee schedule year. e.g. 2026
HCPCS_Code	HCPCS Code	Healthcare Common Procedure Coding System laboratory code. e.g. 0011U
Modifier	Modifier	Optional CPT/HCPCS modifier (or N/A code indicator). e.g. QW
Effective_Date	Effective Date	Effective date for the rate, in YYYYMMDD format. e.g. 20260101
Indicator	Indicator	National rate indicator code. e.g. N
Rate	Rate	Clinical Laboratory Fee Schedule Medicare national reimbursement amount. e.g. $114.43
Short_Description	Short Description	Brief description of the laboratory procedure. e.g. Rx mntr lc-ms/ms oral fluid
Long_Description	Long Description	Standard CMS description of the procedure. e.g. Prescription drug monitoring in oral fluid
Extended_Description	Extended Description	Full comprehensive descriptor including specific target panels and methods.

Working with modifiers

Modifiers in the CLFS adjust the base rates. Other modifiers are applied on claims and adjust payment separately.