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Serum Protein Electrophoresis (SPEP)

CPT 84165

Ordered when a doctor suspects multiple myeloma or another plasma-cell disorder, or to track a known abnormal protein over time.

No national payment amount

Status X is not separately payable under the PFS.

Did Medicare pay separately for CPT 84165 in Q4 2023? Copy link

Not at a published national rate. CPT 84165 carries status X (statutory exclusion) in the Q4 2023 release. The statutory definition of physician services does not include this item. Treat the blank amount as unpriced, not as $0.

Source: Physician relative value file (Q4 2023) · effective October 2023 · materially updated Aug 4, 2026 · compact facts

Can you bill it with another code? Copy link

Enter a second CPT or HCPCS code billed the same date of service to check the current NCCI procedure-to-procedure edit between it and 84165.

See every current NCCI pair for 84165 →

How often 84165 is billed Copy link

Across Original Medicare in CY2024, 84165 ranked #190 of the 7,879 CPT codes billed to Medicare that year, ranked by patients served or total allowed dollars. Patients who received it in 2024 were billed for it an average of 1.7 times that year — more than once per patient.

Beneficiaries
795,224
Office + facility patients combined
Services
1.4M
Times it was billed
Allowed
$18.5M
Total Medicare allowed dollars
Compare: ↑ #189 more popular · 90961 ↓ #191 less popular · 99283

2024 Medicare fee-for-service only, national totals — Medicare Advantage, Medicaid and commercial volume are excluded, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q4 2023 fee schedule the rates above come from.

Common questions Copy link

Why is there no payment amount for 84165?

Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. The blank is deliberate: the amount is either unknown or paid under another provision, so reading it as $0 would be wrong.

Why would a Medicare claim for 84165 be denied or paid less?

Each item below comes from a CMS indicator on this page — not general billing advice.

  • Its status indicator is X (statutory exclusion) — The statutory definition of physician services does not include this item. See status indicators

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Saw this code on your bill? Copy link

For patients
What does CPT code 84165 mean?

CPT code 84165: Serum Protein Electrophoresis (SPEP). A common example is a blood draw ordered after unexplained anemia, persistent bone pain, or an oddly high total protein on earlier routine bloodwork. The lab is looking for one abnormal antibody produced in large quantities, which shows up as a sharp peak where the normal pattern is broad and rounded.

Computation & policy

How this amount is computed Copy link

amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000. To price an RVU figure of your own, use the RVU-to-dollars converter.

Release Q4 2023
Component RVU
Work RVU blank
Practice expense RVU (non-facility) blank
Practice expense RVU (facility) blank
Malpractice RVU blank

Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A blank means CMS publishes no national number for that part. Read it as unknown, and never as zero.

History & related

Rate history by release Copy link

National non-facility amount for 84165 across quarterly releases.

Release Status Non-facility Facility
Q3 2026 Jun 30, 2026 – present X — —
Q2 2026 Mar 10, 2026 – Jun 29, 2026 X — —
Q1 2026 Dec 29, 2025 – Mar 9, 2026 X — —

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Source & method

Show sources

This is computed from CMS's Medicare Physician Fee Schedule Q4 2023 release (schedule pfs, effective October 2023). National amounts apply a GPCI of 1.000 and leave sequestration off. The status indicator decides payability, never the RVU values, so a blank RVU stays blank. Releases are immutable: a rate retrieved for a past quarter always reflects that release. Commercial and cash-pay figures anywhere on this page are arithmetic on the Medicare amount, using commonly cited reimbursement ranges. They're illustrative, and no nationwide claims database stands behind them. Our methodology covers all of this in depth — sourcing, parsing, versioning, and how claims are cross-checked before they ship.

Description written from primary sources: CMS Medicare Physician Fee Schedule Relative Value Files. Not derived from AMA CPT descriptor text.

Physician relative value file (Q4 2023) · rvu23d.zip (PPRRVU23_OCT.csv row 15,460)

Conversion factor $33.8872 read from the same file, row 11, column 25.

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

This link keeps pointing at the Q4 2023 figures, even after a newer release lands.

CPT 84165 Medicare Physician Fee Schedule rate (Q4 2023). Localis. https://localishealth.com/cpt/84165/2023/D