AFP Tumor Marker Test Cost and Medicare Coverage (CPT 82105)

Also called: alpha-fetoprotein · AFP tumor marker · AFP blood test · α-fetoprotein — all the same test, CPT 82105.

The short answer

Covered for a short, named list of people: those already at high risk of liver cancer because of a specific liver condition, those whose doctor is sorting out whether a growth in the liver is cancer, and those with a germ cell tumor. Medicare’s national policy (NCD 190.25, the same in every state) says AFP “is useful for the diagnosis of hepatocellular carcinoma in high-risk patients,” and it names the conditions it means: “alcoholic cirrhosis, cirrhosis of viral etiology, hemochromatosis, and alpha 1-antitrypsin deficiency.” It also covers AFP for “separating patients with benign hepatocellular neoplasms or metastases from those with hepatocellular carcinoma,” and as a marker for germ cell tumors “of the testis, ovary, retroperitoneum, and mediastinum.”

That is the whole covered list. This policy is unusual in having no limitations section at all, no frequency rule, and no “not covered for” sentence; it never uses the word screening. The boundary is entirely the named conditions. If none of them is on your order, there is nothing in the policy for the claim to stand on.

AFP is not a test to check whether you have cancer. Quest’s directory says “AFP is not recommended as a screening procedure to detect cancer in the general population,” and MedlinePlus says that “because high levels of AFP don’t always mean cancer, health care providers don’t use the results from an AFP test alone to screen for or diagnose cancer.”

When Medicare DOES cover it

The national policy’s covered picture, in plain English:

• Diagnosing liver cancer in someone already at high risk, where the policy’s own examples of high risk are cirrhosis from alcohol, cirrhosis from a viral cause, hemochromatosis (iron overload), and alpha 1-antitrypsin deficiency. Known liver disease of these kinds is the setting this policy is written for; the liver enzyme tests that usually come first, such as the GGT, have their own pages.
• Telling a benign liver growth, or a cancer that has spread to the liver from elsewhere, apart from a cancer that started in the liver. The policy’s phrase is “separating patients with benign hepatocellular neoplasms or metastases from those with hepatocellular carcinoma.”
• Marking a germ cell tumor of the testis, ovary, retroperitoneum (the back of the abdomen), or mediastinum (the middle of the chest). The policy calls AFP “a non-specific tumor associated antigen” for this use.
• Monitoring how a cancer responds to treatment. The policy’s description says AFP “is effective as a biochemical marker for monitoring the response of certain malignancies to therapy,” and MedlinePlus says a level that rises during or after treatment may mean the treatment is not working or the cancer has come back; that reading is your oncologist’s.

If one of these genuinely describes your situation, the diagnosis for it belongs on your doctor’s order, and coverage follows.

When Medicare does NOT cover it

The policy has no limitations section, so there is no list of exclusions to quote. What there is instead is a short list of covered situations, and anything outside it is uncovered by omission.

• AFP as a general cancer check, with no liver condition, no liver growth, and no germ cell tumor on the order. The policy never mentions screening, and neither Quest nor MedlinePlus recommends AFP for it.
• AFP for a liver condition that is not on the policy’s list. The policy names four high-risk conditions. Hepatitis C without cirrhosis, for example, is not one of them; the hepatitis C screening benefit is a separate test with its own rules.
• AFP for a pregnancy. Cleveland Clinic’s page is mainly about the AFP test used in pregnancy, a different test for a different purpose. This policy covers the tumor marker only and does not mention maternal AFP at all.

(Never ask anyone to change a code just to get coverage; that is fraud. But doctors often have a legitimate reason for the test that simply wasn’t written down.)

What you pay if it IS covered: $0

Covered lab tests cost Medicare patients nothing, with no deductible and no 20% coinsurance. Medicare pays the lab $16.77 for an AFP tumor marker test, and you owe zero.

What you pay if it is NOT covered, read this before you sign

Quest’s own test directory flags the AFP tumor marker test as “subject to a Medicare Limited Coverage Policy” that “may require a signed ABN when ordering.” (Labcorp’s page carries no such notice.) If AFP is on your order without one of the policy’s named conditions behind it, expect the Advance Beneficiary Notice (ABN), the signature pad, committing you to the lab’s own billing rates if Medicare denies the claim. Before you sign:

1. Ask the lab to print exactly what you would owe. You’re entitled to see the number in black and white first. For perspective: when Medicare covers this exact test, it pays the lab $16.77.
2. Know the direct prices: an AFP tumor marker test sells for about $59.90 all in at Ulta Lab Tests (partner link in the table; our commission is disclosed there) and $73.00 all in at Jason Health (jasonhealth.com, including their flat $18 lab-collection fee per order). Quest’s consumer site, Labcorp OnDemand, and Personalabs do not sell it. Same certified labs, same blood draw.

Before you sign the pad, 60-second checklist

1. Ask: “Can you print what I’ll owe if Medicare doesn’t pay?”
2. Ask your doctor: “Is this because of a liver condition or a tumor that is already on my chart, and is that diagnosis on the order?”
3. Compare the printed price to the direct-purchase prices before deciding how to proceed.

What counts as a “normal” AFP level

Start with the range printed on your own report. For AFP, that is close to the only place to look: MedlinePlus and Cleveland Clinic both publish no number, Quest’s directory hides its range until a service area is chosen, and Labcorp’s reference intervals change with age and sex.

• Labcorp’s reference intervals for adults 18 to 30 are 0.0 to 5.7 ng/mL for men and 0.0 to 4.7 ng/mL for women, and for adults 31 to 50 they are 0.0 to 6.9 ng/mL for men and 0.0 to 6.4 ng/mL for women; other age bands have their own figures.
• MedlinePlus and Cleveland Clinic give no numeric range at all.

None of the sources we checked gives a treatment target for AFP, so there is no “clinical target” to add here. Two things matter more than any number. The National Cancer Institute says that “having an elevated level of a tumor marker does not mean that someone has cancer” and that “noncancerous conditions can sometimes cause an increase in the level of a tumor marker”; Cleveland Clinic lists cirrhosis, hepatitis A, B, or C, and toxic or autoimmune hepatitis among the reasons an adult’s AFP may be high. And the reverse is also true: NCI says “not everyone with a particular type of cancer will have a higher level of a tumor marker associated with that cancer,” so a normal AFP does not rule cancer out.

(Where lab ranges and “optimal” ranges come from, and who decides.)

This page can tell you where those numbers came from. It cannot tell you what yours means; that reading belongs to your doctor, alongside your imaging, your liver tests, and your history.

Quick questions people ask

What is an AFP tumor marker test? MedlinePlus describes AFP as “a protein that the liver makes when its cells are growing and dividing to make new cells.” The test measures how much of it is in your blood. The National Cancer Institute lists AFP as a marker for “liver cancer, ovarian cancer, and germ cell tumors.” On billing paperwork it is CPT code 82105.

Is AFP a cancer screening test? No. Quest’s directory says AFP “is not recommended as a screening procedure to detect cancer in the general population,” and MedlinePlus says providers “don’t use the results from an AFP test alone to screen for or diagnose cancer.” NCI adds that studies of whether tumor markers can screen for cancer “have generally found that these markers do not work well for screening.” Medicare’s policy never mentions screening, so there is no screening claim to make.

Does a high AFP mean cancer? Not by itself. NCI says an elevated tumor marker “does not mean that someone has cancer,” and Cleveland Clinic’s list of reasons an adult’s AFP may be high includes cirrhosis and hepatitis alongside liver cancer. NCI says tumor marker results “are usually combined with the results of other tests, such as biopsies or imaging, to diagnose cancer.” What your result means is a conversation with your doctor.

Do you have to fast for an AFP test? MedlinePlus says “you don’t need any special preparations for an AFP tumor marker test,” and Quest’s directory lists no patient preparation. If your order says otherwise, follow the order.

Is this the same as the AFP test in pregnancy? No. Cleveland Clinic’s AFP page is mainly about the pregnancy test. Medicare’s tumor marker policy covers the tumor marker use only, and its covered list is liver conditions, liver growths, and germ cell tumors.

Sources and data dates

Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate for 82105). Coverage rules: CMS Medicare Coverage Database, NCD 190.25 (Alpha-fetoprotein), a national policy identical in every state, and the same text in the NCD Manual, Chapter 1, Part 3. Test descriptions, preparation, and ranges: National Cancer Institute (Tumor Markers fact sheet and list), MedlinePlus (AFP Tumor Marker Test; Tumor Marker Tests), Cleveland Clinic (Alpha-Fetoprotein Test), Quest test 237, Labcorp test 002253. Consumer prices checked September 2026. Information current as of the date shown above; coverage is always determined by Medicare when your claim is processed.

ClaraCover provides information, not medical, billing, or insurance advice. Talk to your doctor about what tests you need.