Medicare Lab Fee Reimbursement 2026 - Vendor Pricing.xlsx
XLSX spreadsheet 236 KB Posted
- Attached to
- DHS IFB Laboratory Services REBID
- Solicitation number
- 27-444DHS-PROCU-B-54074
- Issued by
- Illinois
About this file
This is a Medicare Lab Fee Reimbursement pricing schedule document for the Department of Health and Human Services (DHS) related to the DHS IFB Laboratory Services REBID for 14 Mental Health and Developmental Disability facilities throughout Illinois. The document provides the 2026 Clinical Diagnostic Laboratory Fee Schedule with CPT codes, descriptions, and Medicare reimbursement rates for numerous laboratory tests. The file contains approximately 330 laboratory test codes ranging from basic blood typing and drug screening tests to advanced molecular pathology, genomic sequencing, and specialized oncology assessments. The estimated annual DHS usage for laboratory services is $700,000, and vendors are instructed to enter pricing for five specific tests listed as individual line items in the BidBuy system using a markup percentage (positive percentage) or discount percentage (negative percentage) applied to the base Medicare reimbursement rates.
Vendors must calculate their total bid by multiplying the estimated $700,000 annual usage by their proposed markup or discount percentage and enter this calculated amount in BidBuy for both the Initial Term and Renewal Term line items. The pricing schedule covers an extensive range of laboratory services including clinical chemistry, molecular pathology, infectious disease detection, oncology testing, pharmacogenomics, and specialized diagnostic tests effective January 1, 2026. The document notes that certain HCPCS codes (G2023, G2024, U0003, U0004, U0005) related to COVID-19 Public Health Emergency testing will no longer be payable after May 12, 2023, and have been terminated. Bidders are required to provide markup or discount pricing percentages for all listed tests to establish their competitive fee schedules for the laboratory services contract.
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Other files
| File | Type | Posted |
|---|---|---|
| vendor-disclosure-formerly-forms-a-v27-1-2026-0624~1.docx | DOCX document | |
| ipg-active-registered-vendor-disclosure-formerly-forms-b-v-26-1-8-26-2025-1~34.docx | DOCX document | |
| invitation-for-bid-offer-to-the-state-of-illinois-B-54074.pdf | ||
| DHS IFB Laboratory Services-B-54074.docx | DOCX document | |
| invitation-for-bid-vendor-instructions-and-requirements-B-54074.docx | DOCX document | |
| BEP Utilization Plan v.26.1~9.pdf |
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Medicare Lab Fee Reimbursement
| Instructions Below. | ||||||||||
| Below is the FY26 Medicare Reimbursement Fee Schedule. | ||||||||||
| Five tests listed as individual lines in BidBuy, enter pricing for those test in BidBuy. | ||||||||||
| Please enter your markup +/discount - pricing as percentage for all below tests here. | Enter a positive percentage for a markup, or a negative percentage for a discount | |||||||||
| Estimated DHS Usage Annually | $700,000 | Usage x Markup +/Discount - | $700,000.00 | This number should be entered into BidBuy as your bid for Initial Term and Renewal Term, line items 1 & 2 | ||||||
| 2026 Clinical Diagnostic Laboratory Fee Schedule | ||||||||||
| CPT codes | descriptions and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. | |||||||||
| The Department of Health and Human Services is planning for the federal Public Health Emergency for COVID-19 (PHE) | declared under Section 319 of the Public Health Service Act | to expire at the end of the day on May 11 | 2023. Because of the termination of the PHE | HCPCS codes G2023 | G2024 | U0003 | U0004 | and U0005 will no longer be payable for dates of service on or after May 12 | 2023 | and the HCPCS codes will be terminated. |
| YEAR | HCPCS | MOD | EFF_DATE | INDICATOR | RATE | SHORTDESC | LONGDESC | EXTENDEDLONGDESC | ||
| 2026 | 0001U | 20260101 | N | $720.00 | Rbc dna hea 35 ag 11 bld grp | Red blood cell typing | Red blood cell antigen typing, dna, human erythrocyte antigen gene analysis of 35 antigens from 11 blood groups, utilizing whole blood, common rbc alleles reported | |||
| 2026 | 0002M | 20260101 | N | $503.40 | Liver dis 10 assays w/ash | Molecular pathology test for liver disease, including alcohol liver disease | Liver disease, ten biochemical assays (alt, a2-macroglobulin, apolipoprotein a-1, total bilirubin, ggt, haptoglobin, ast, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algorithm reported as quantitative scores for fibrosis, steatosis and alcoholic steatohepatitis (ash) | |||
| 2026 | 0002U | 20260101 | N | $25.00 | Onc clrct 3 ur metab alg plp | Measurement of substances in urine to predict likelihood of polyps in large | Oncology (colorectal), quantitative assessment of three urine metabolites (ascorbic acid, succinic acid and carnitine) by liquid chromatography with tandem mass spectrometry (lc-ms/ms) using multiple reaction monitoring acquisition, algorithm reported as likelihood of adenomatous polyps | |||
| 2026 | 0003M | 20260101 | N | $503.40 | Liver dis 10 assays w/nash | Molecular pathology test for liver disease, including non-alcohol liver disease | Liver disease, ten biochemical assays (alt, a2-macroglobulin, apolipoprotein a-1, total bilirubin, ggt, haptoglobin, ast, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algorithm reported as quantitative scores for fibrosis, steatosis and nonalcoholic steatohepatitis (nash) | |||
| 2026 | 0003U | 20260101 | N | $950.00 | Onc ovar 5 prtn ser alg scor | Measurement of proteins associated with ovarian cancer in serum | Oncology (ovarian) biochemical assays of five proteins (apolipoprotein a-1, ca 125 ii, follicle stimulating hormone, human epididymis protein 4, transferrin), utilizing serum, algorithm reported as a likelihood score | |||
| 2026 | 0004M | 20260101 | N | $79.00 | Scoliosis dna alys | Molecular pathology test for genetic analysis of curved spine deformity | Scoliosis, dna analysis of 53 single nucleotide polymorphisms (snps), using saliva, prognostic algorithm reported as a risk score | |||
| 2026 | 0005U | 20260101 | N | $760.00 | Onco prst8 3 gene ur alg | Test for detecting genes associated with prostate cancer in urine | Oncology (prostate) gene expression profile by real-time rt-pcr of 3 genes (erg, pca3, and spdef), urine, algorithm reported as risk score | |||
| 2026 | 0006M | 20260101 | N | $150.00 | Onc hep gene risk classifier | Molecular pathology test for genetic analysis of liver tumor (HeproDX) | Oncology (hepatic), mrna expression levels of 161 genes, utilizing fresh hepatocellular carcinoma tumor tissue, with alpha-fetoprotein level, algorithm reported as a risk classifier | |||
| 2026 | 0007M | 20260101 | N | $375.00 | Onc gastro 51 gene nomogram | Molecular pathology test for genetic analysis of tumors in the digestive system | Oncology (gastrointestinal neuroendocrine tumors), real-time pcr expression analysis of 51 genes, utilizing whole peripheral blood, algorithm reported as a nomogram of tumor disease index | |||
| 2026 | 0007U | 20260101 | N | $114.43 | Rx test prsmv ur w/def conf | Testing for presence of drug in urine | Drug test(s), presumptive, with definitive confirmation of positive results, any number of drug classes, urine, includes specimen verification including dna authentication in comparison to buccal dna, per date of service | |||
| 2026 | 0008U | 20260101 | N | $597.91 | Hpylori detcj abx rstnc dna | Test for detecting Helicobacter pylori genes associated with antibiotic | Helicobacter pylori detection and antibiotic resistance, dna, 16s and 23s rrna, gyra, pbp1, rdxa and rpob, next generation sequencing, formalin-fixed paraffin embedded or fresh tissue or fecal sample, predictive, reported as positive or negative for resistance to clarithromycin, fluoroquinolones, metronidazole, amoxicillin, tetracycline and rifabutin | |||
| 2026 | 0009U | 20260101 | N | $107.00 | Onc brst ca erbb2 amp/nonamp | Gene analysis of breast tumor tissue | Oncology (breast cancer), erbb2 (her2) copy number by fish, tumor cells from formalin fixed paraffin embedded tissue isolated using image-based dielectrophoresis (dep) sorting, reported as erbb2 gene amplified or non-amplified | |||
| 2026 | 0010U | 20260101 | N | $427.26 | Nfct ds strn typ whl gen seq | Typing of bacterial strain | Infectious disease (bacterial), strain typing by whole genome sequencing, phylogenetic-based report of strain relatedness, per submitted isolate | |||
| 2026 | 0011M | 20260101 | N | $760.00 | Onc prst8 ca mrna 12 gen alg | Molecular pathology test for genetic analysis of prostate tumor (NeoLAB | Oncology, prostate cancer, mrna expression assay of 12 genes (10 content and 2 housekeeping), rt-pcr test utilizing blood plasma and urine, algorithms to predict high-grade prostate cancer risk | |||
| 2026 | 0011U | 20260101 | N | $114.43 | Rx mntr lc-ms/ms oral fluid | Prescription drug monitoring in oral fluid | Prescription drug monitoring, evaluation of drugs present by lc-ms/ms, using oral fluid, reported as a comparison to an estimated steady-state range, per date of service including all drug compounds and metabolites | |||
| 2026 | 0012M | 20260101 | N | $760.00 | Onc mrna 5 gen rsk urthl ca | Molecular pathology test for genetic analysis of bladder tumor (Cxbladder | Oncology (urothelial), mrna, gene expression profiling by real-time quantitative pcr of five genes (mdk, hoxa13, cdc2 [cdk1], igfbp5, and cxcr2), utilizing urine, algorithm reported as a risk score for having urothelial carcinoma | |||
| 2026 | 0013M | 20260101 | N | $760.00 | Onc mrna 5 gen recr urthl ca | Molecular pathology test for genetic analysis of recurrent bladder tumor | Oncology (urothelial), mrna, gene expression profiling by real-time quantitative pcr of five genes (mdk, hoxa13, cdc2 [cdk1], igfbp5, and cxcr2), utilizing urine, algorithm reported as a risk score for having recurrent urothelial carcinoma | |||
| 2026 | 0015M | 20260101 | N | $1,305.37 | Adrnl cortcl tum bchm asy 25 | Molecular pathology test for genetic analysis of kidney gland tumor (Adrenal | Adrenal cortical tumor, biochemical assay of 25 steroid markers, utilizing 24-hour urine specimen and clinical parameters, prognostic algorithm reported as a clinical risk and integrated clinical steroid risk for adrenal cortical carcinoma, adenoma, or other adrenal malignancy | |||
| 2026 | 0016M | 20260101 | N | $3,489.63 | Onc bladder mrna 219 gen alg | Molecular pathology test for genetic analysis of bladder tumor (Decipher | Oncology (bladder), mrna, microarray gene expression profiling of 219 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as molecular subtype (luminal, luminal infiltrated, basal, basal claudin-low, neuroendocrine-like) | |||
| 2026 | 0016U | 20260101 | N | $163.96 | Onc hmtlmf neo rna bcr/abl1 | RNA test for detecting gene abnormality associated with blood and lymphatic | Oncology (hematolymphoid neoplasia), rna, bcr/abl1 major and minor breakpoint fusion transcripts, quantitative pcr amplification, blood or bone marrow, report of fusion not detected or detected with quantitation | |||
| 2026 | 0017M | 20260101 | N | $2,510.21 | Onc dlbcl mrna 20 genes alg | mRNA gene expression profiling by fluorescent probe hybridization of 20 genes | Oncology (diffuse large b-cell lymphoma [dlbcl]), mrna, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algorithm reported as cell of origin | |||
| 2026 | 0017U | 20260101 | N | $91.66 | Onc hmtlmf neo jak2 mut dna | JAK2 mutation test for detecting gene abnormality associated with blood and | Oncology (hematolymphoid neoplasia), jak2 mutation, dna, pcr amplification of exons 12-14 and sequence analysis, blood or bone marrow, report of jak2 mutation not detected or detected | |||
| 2026 | 0018M | 20260101 | N | $640.73 | Trnsplj rnl meas cd154+cll | Measurement of kidney donor and third-party-induced CD154+T-cytotoxic memory | Transplantation medicine (allograft rejection, renal), measurement of donor and third-party-induced cd154+t-cytotoxic memory cells, utilizing whole peripheral blood, algorithm reported as a rejection risk score | |||
| 2026 | 0018U | 20260101 | N | $3,002.09 | Onc thyr 10 microrna seq alg | MicroRNA gene analysis of thyroid nodule tissue | Oncology (thyroid), microrna profiling by rt-pcr of 10 microrna sequences, utilizing fine needle aspirate, algorithm reported as a positive or negative result for moderate to high risk of malignancy | |||
| 2026 | 0019M | 20260101 | N | $712.40 | Cv ds plasma alys prtn bmrk | Analysis of protein biomarkers in plasma with results reported as likelihood | Cardiovascular disease, plasma, analysis of protein biomarkers by aptamer-based microarray and algorithm reported as 4-year likelihood of coronary event in high-risk populations | |||
| 2026 | 0019U | 20260101 | N | $3,675.00 | Onc rna tiss predict alg | RNA gene analysis of tumor tissue | Oncology, rna, gene expression by whole transcriptome sequencing, formalin-fixed paraffin embedded tissue or fresh frozen tissue, predictive algorithm reported as potential targets for therapeutic agents | |||
| 2026 | 0020M | 20260101 | N | $2,500.00 | Onc cns alys 30000 dna loci | Analysis of DNA from tumor tissue with results reported as probability of | Oncology (central nervous system), analysis of 30000 dna methylation loci by methylation array, utilizing dna extracted from tumor tissue, diagnostic algorithm reported as probability of matching a reference tumor subclass | |||
| 2026 | 0021U | 20260101 | N | $760.00 | Onc prst8 detcj 8 autoantb | Detection of 8 autoantibodies in prostate tissue | Oncology (prostate), detection of 8 autoantibodies (arf 6, nkx3-1, 5'-utr-bmi1, cep 164, 3'-utr-ropporin, desmocollin, aurkaip-1, csnk2a2), multiplexed immunoassay and flow cytometry serum, algorithm reported as risk score | |||
| 2026 | 0022U | 20260101 | N | $1,950.00 | Tgsap nsm lung neo dna&rna23 | DNA and RNA targeted sequencing analysis of 1-23 genes associated with | Targeted genomic sequence analysis panel, non-small cell lung neoplasia, dna and rna analysis, 23 genes, interrogation for sequence variants and rearrangements, reported as presence or absence of variants and associated therapy(ies) to consider | |||
| 2026 | 0023U | 20260101 | N | $248.51 | Onc aml dna detcj/nondetcj | DNA gene analysis for acute myelogenous leukemia | Oncology (acute myelogenous leukemia), dna, genotyping of internal tandem duplication, p.d835, p.i836, using mononuclear cells, reported as detection or non-detection of flt3 mutation and indication for or against the use of midostaurin | |||
| 2026 | 0024U | 20260101 | N | $34.19 | Glyca nuc mr spectrsc quan | Measurement of glycosylated acute phase proteins | Glycosylated acute phase proteins (glyca), nuclear magnetic resonance spectroscopy, quantitative | |||
| 2026 | 0025U | 20260101 | N | $114.43 | Tenofovir liq chrom ur quan | Measurement of tenovir in urine | Tenofovir, by liquid chromatography with tandem mass spectrometry (lc-ms/ms), urine, quantitative | |||
| 2026 | 0026U | 20260101 | N | $3,600.00 | Onc thyr dna&mrna 112 genes | DNA and microRNA gene analysis of thyroid nodule tissue | Oncology (thyroid), dna and mrna of 112 genes, next-generation sequencing, fine needle aspirate of thyroid nodule, algorithmic analysis reported as a categorical result ("positive, high probability of malignancy" or "negative, low probability of malignancy") | |||
| 2026 | 0027U | 20260101 | N | $121.91 | Jak2 gene trgt seq alys | Gene analysis (Janus kinase 2) of targeted sequence exons 12-15 | Jak2 (janus kinase 2) (eg, myeloproliferative disorder) gene analysis, targeted sequence analysis exons 12-15 | |||
| 2026 | 0029U | 20260101 | N | $742.27 | Rx metab advrs trgt seq alys | Gene analysis of targeted sequences for adverse drug reactions and drug response | Drug metabolism (adverse drug reactions and drug response), targeted sequence analysis (ie, cyp1a2, cyp2c19, cyp2c9, cyp2d6, cyp3a4, cyp3a5, cyp4f2, slco1b1, vkorc1 and rs12777823) | |||
| 2026 | 0030U | 20260101 | N | $134.13 | Rx metab warf trgt seq alys | Gene analysis of targeted sequences for warfarin drug response | Drug metabolism (warfarin drug response), targeted sequence analysis (ie, cyp2c9, cyp4f2, vkorc1, rs12777823) | |||
| 2026 | 0031U | 20260101 | N | $174.81 | Cyp1a2 gene | Gene analysis (cytochrome P450 family 1, subfamily A, member 2) for common | Cyp1a2 (cytochrome p450 family 1, subfamily a, member 2) (eg, drug metabolism) gene analysis, common variants (ie, *1f, *1k, *6, *7) | |||
| 2026 | 0032U | 20260101 | N | $174.81 | Comt gene | Gene analysis (catechol-O-methyltransferase) for c.472G>A (rs4680) variant | Comt (catechol-o-methyltransferase) (drug metabolism) gene analysis, c.472g>a (rs4680) variant | |||
| 2026 | 0034U | 20260101 | N | $466.17 | Tpmt nudt15 genes | Gene analysis (thiopurine S-methyltransferase) for common variants | Tpmt (thiopurine s-methyltransferase), nudt15 (nudix hydroxylase 15)(eg, thiopurine metabolism), gene analysis, common variants (ie, tpmt *2, *3a, *3b, *3c, *4, *5, *6, *8, *12; nudt15 *3, *4, *5) | |||
| 2026 | 0035U | 20260101 | N | $540.99 | Neuro csf prion prtn qual | Testing for presence of prion protein in cerebrospinal fluid | Neurology (prion disease), cerebrospinal fluid, detection of prion protein by quaking-induced conformational conversion, qualitative | |||
| 2026 | 0036U | 20260101 | N | $4,780.00 | Xome tum & nml spec seq alys | Exome gene analysis for somatic mutation in tumor tissue | Exome (ie, somatic mutations), paired formalin-fixed paraffin-embedded tumor tissue and normal specimen, sequence analyses | |||
| 2026 | 0037U | 20260101 | N | $3,500.00 | Trgt gen seq dna 324 genes | DNA gene analysis of 324 genes in solid organ tumor tissue | Targeted genomic sequence analysis, solid organ neoplasm, dna analysis of 324 genes, interrogation for sequence variants, gene copy number amplifications, gene rearrangements, microsatellite instability and tumor mutational burden | |||
| 2026 | 0038U | 20260101 | N | $29.60 | Vitamin d srm microsamp quan | Measurement of vitamin D in serum | Vitamin d, 25 hydroxy d2 and d3, by lc-ms/ms, serum microsample, quantitative | |||
| 2026 | 0039U | 20260101 | N | $13.74 | Dna antb 2strand hi avidity | Testing for anti-DNA antibody | Deoxyribonucleic acid (dna) antibody, double stranded, high avidity | |||
| 2026 | 0040U | 20260101 | N | $409.90 | Bcr/abl1 gene major bp quan | Gene analysis (t(9;22)) for translocation analysis | Bcr/abl1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis, major breakpoint, quantitative | |||
| 2026 | 0041U | 20260101 | N | $17.21 | B brgdrferi antb 5 prtn igm | IgM antibody detection test for Borrelia burgdorferi | Borrelia burgdorferi, antibody detection of 5 recombinant protein groups, by immunoblot, igm | |||
| 2026 | 0042U | 20260101 | N | $17.21 | B brgdrferi antb 12 prtn igg | IgG antibody detection test for Borrelia burgdorferi | Borrelia burgdorferi, antibody detection of 12 recombinant protein groups, by immunoblot, igg | |||
| 2026 | 0043U | 20260101 | N | $14.86 | Tbrf b grp antb 4 prtn igm | IgM antibody detection test for Tick-Borne Relapsing Fever Borrelia group (IgM) | Tick-borne relapsing fever borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, igm | |||
| 2026 | 0044U | 20260101 | N | $14.86 | Tbrf b grp antb 4 prtn igg | IgM antibody detection test for Tick-Borne Relapsing Fever Borrelia group (IgG) | Tick-borne relapsing fever borrelia group, antibody detection to 4 recombinant protein groups, by immunoblot, igg | |||
| 2026 | 0045U | 20260101 | N | $3,873.00 | Onc brst dux carc is 12 gene | mRNA gene analysis of 12 genes in breast ductal carcinoma in situ tumor tissue | Oncology (breast ductal carcinoma in situ), mrna, gene expression profiling by real-time rt-pcr of 12 genes (7 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as recurrence score | |||
| 2026 | 0046U | 20260101 | N | $407.43 | Flt3 gene itd variants quan | Gene analysis (fms-related tyrosine kinase 3) for internal tandem duplication | Flt3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia) internal tandem duplication (itd) variants, quantitative | |||
| 2026 | 0047U | 20260101 | N | $3,873.00 | Onc prst8 mrna 17 gene alg | mRNA gene analysis of 17 genes in prostate tumor tissue | Oncology (prostate), mrna, gene expression profiling by real-time rt-pcr of 17 genes (12 content and 5 housekeeping), utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a risk score | |||
| 2026 | 0048U | 20260101 | N | $2,919.60 | Onc sld org neo dna 468 gene | DNA gene analysis of 468 genes in solid organ tumor tissue | Oncology (solid organ neoplasia), dna, targeted sequencing of protein-coding exons of 468 cancer-associated genes, including interrogation for somatic mutations and microsatellite instability, matched with normal specimens, utilizing formalin-fixed paraffin-embedded tumor tissue, report of clinically significant mutation(s) | |||
| 2026 | 0049U | 20260101 | N | $407.43 | Npm1 gene analysis quan | Gene analysis (nucleophosmin) | Npm1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, quantitative | |||
| 2026 | 0050U | 20260101 | N | $2,916.60 | Trgt gen seq dna 194 genes | DNA gene analysis of targeted sequences in 194 genes for acute myelogenous | Targeted genomic sequence analysis panel, acute myelogenous leukemia, dna analysis, 194 genes, interrogation for sequence variants, copy number variants or rearrangements | |||
| 2026 | 0051U | 20260101 | N | $246.92 | Rx mntr lc-ms/ms ur/bld 31 | Testing for presence of 31 prescription drugs in urine or blood specimen | Prescription drug monitoring, evaluation of drugs present by liquid chromatography tandem mass spectrometry (lc-ms/ms), urine or blood, 31 drug panel, reported as quantitative results, detected or not detected, per date of service | |||
| 2026 | 0052U | 20260101 | N | $33.86 | Lpoprtn bld w/5 maj classes | Measurement of all five major lipoprotein classes and subclasses in blood | Lipoprotein, blood, high resolution fractionation and quantitation of lipoproteins, including all five major lipoprotein classes and subclasses of hdl, ldl, and vldl by vertical auto profile ultracentrifugation | |||
| 2026 | 0054U | 20260101 | N | $198.74 | Rx mntr 14+ drugs & sbsts | Measurement of 14 or more drug classes in capillary blood | Prescription drug monitoring, 14 or more classes of drugs and substances, definitive tandem mass spectrometry with chromatography, capillary blood, quantitative report with therapeutic and toxic ranges, including steady-state range for the prescribed dose when detected, per date of service | |||
| 2026 | 0055U | 20260101 | N | $3,240.00 | Card hrt trnspl 96 dna seq | DNA gene analysis of 96 target sequences in plasma for heart transplant | Cardiology (heart transplant), cell-free dna, pcr assay of 96 dna target sequences (94 single nucleotide polymorphism targets and two control targets), plasma | |||
| 2026 | 0058U | 20260101 | N | $322.96 | Onc merkel cll carc srm quan | Measurement of antibodies to Merkel cell polyoma virus oncoprotein in serum | Oncology (merkel cell carcinoma), detection of antibodies to the merkel cell polyoma virus oncoprotein (small t antigen), serum, quantitative | |||
| 2026 | 0059U | 20260101 | N | $322.96 | Onc merkel cll carc srm +/- | Test for presence of antibodies to Merkel cell polyoma virus oncoprotein in | Oncology (merkel cell carcinoma), detection of antibodies to the merkel cell polyoma virus capsid protein (vp1), serum, reported as positive or negative | |||
| 2026 | 0060U | 20260101 | N | $759.05 | Twn zyg gen seq alys chrms2 | Gene analysis for identical twins in maternal blood | Twin zygosity, genomic-targeted sequence analysis of chromosome 2, using circulating cell-free fetal dna in maternal blood | |||
| 2026 | 0061U | 20260101 | N | $25.10 | Tc meas 5 bmrk sfdi m-s alys | Spatial frequency domain imaging of skin | Transcutaneous measurement of five biomarkers (tissue oxygenation [sto2], oxyhemoglobin [cthbo2], deoxyhemoglobin [cthbr], papillary and reticular dermal hemoglobin concentrations [cthb1 and cthb2]), using spatial frequency domain imaging (sfdi) and multi-spectral analysis | |||
| 2026 | 0062U | 20260101 | N | $380.72 | Ai sle igg&igm alys 80 bmrk | IgG and IgM analysis of 80 biomarkers of systemic lupus erythematosus in serum | Autoimmune (systemic lupus erythematosus), igg and igm analysis of 80 biomarkers, utilizing serum, algorithm reported with a risk score | |||
| 2026 | 0063U | 20260101 | N | $750.00 | Neuro autism 32 amines alg | Testing for amines associated with autism spectrum disorder in plasma | Neurology (autism), 32 amines by lc-ms/ms, using plasma, algorithm reported as metabolic signature associated with autism spectrum disorder | |||
| 2026 | 0064U | 20260101 | N | $31.33 | Antb tp total&rpr ia qual | Antibody testing for syphilis | Antibody, treponema pallidum, total and rapid plasma reagin (rpr), immunoassay, qualitative | |||
| 2026 | 0065U | 20260101 | N | $18.09 | Syfls tst nontreponemal antb | Non-antibody testing for syphilis | Syphilis test, non-treponemal antibody, immunoassay, qualitative (rpr) | |||
| 2026 | 0067U | 20260101 | N | $1,897.00 | Onc brst imhchem prfl 4 bmrk | Protein expression profiling of 4 biomarkers of breast cancer in precancerous | Oncology (breast), immunohistochemistry, protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [mmp-1], carcinoembryonic antigen-related cell adhesion molecule 6 [ceacam6], hyaluronoglucosaminidase [hyal1], highly expressed in cancer protein [hec1]), formalin-fixed paraffin-embedded precancerous breast tissue, algorithm reported as carcinoma risk score | |||
| 2026 | 0068U | 20260101 | N | $142.63 | Candida species pnl amp prb | Detection of Candida species by amplified probe | Candida species panel (c. albicans, c. glabrata, c. parapsilosis, c. kruseii, c tropicalis, and c. auris), amplified probe technique with qualitative report of the presence or absence of each species | |||
| 2026 | 0069U | 20260101 | N | $380.00 | Onc clrct microrna mir-31-3p | mRNA expression profiling of miR-31-3 in colon tumor tissue | Oncology (colorectal), microrna, rt-pcr expression profiling of mir-31-3p, formalin-fixed paraffin-embedded tissue, algorithm reported as an expression sco | |||
| 2026 | 0070U | 20260101 | N | $676.37 | Cyp2d6 gen com&slct rar vrnt | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) for | Cyp2d6 (cytochrome p450, family 2, subfamily d, polypeptide 6) (eg, drug metabolism) gene analysis, common and select rare variants (ie, *2, *3, *4, *4n, *5, *6, *7, *8, *9, *10, *11, *12, *13, *14a, *14b, *15, *17, *29, *35, *36, *41, *57, *61, *63, *68, *83, *xn) | |||
| 2026 | 0071U | 20260101 | N | $600.00 | Cyp2d6 full gene sequence | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) full | Cyp2d6 (cytochrome p450, family 2, subfamily d, polypeptide 6) (eg, drug metabolism) gene analysis, full gene sequence (list separately in addition to code for primary procedure) | |||
| 2026 | 0072U | 20260101 | N | $450.91 | Cyp2d6 gen cyp2d6-2d7 hybrid | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted | Cyp2d6 (cytochrome p450, family 2, subfamily d, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, cyp2d6-2d7 hybrid gene) (list separately in addition to code for primary procedure) | |||
| 2026 | 0073U | 20260101 | N | $450.91 | Cyp2d6 gen cyp2d7-2d6 hybrid | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted | Cyp2d6 (cytochrome p450, family 2, subfamily d, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, cyp2d7-2d6 hybrid gene) (list separately in addition to code for primary procedure) | |||
| 2026 | 0074U | 20260101 | N | $450.91 | Cyp2d6 nonduplicated gene | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted | Cyp2d6 (cytochrome p450, family 2, subfamily d, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, non-duplicated gene when duplication/multiplication is trans) (list separately in addition to code for primary procedure) | |||
| 2026 | 0075U | 20260101 | N | $450.91 | Cyp2d6 5' gene dup/mlt | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted | Cyp2d6 (cytochrome p450, family 2, subfamily d, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, 5' gene duplication/multiplication) (list separately in addition to code for primary procedure) | |||
| 2026 | 0076U | 20260101 | N | $450.91 | Cyp2d6 3' gene dup/mlt | Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted | Cyp2d6 (cytochrome p450, family 2, subfamily d, polypeptide 6) (eg, drug metabolism) gene analysis, targeted sequence analysis (ie, 3' gene duplication/ multiplication) (list separately in addition to code for primary procedure) | |||
| 2026 | 0077U | 20260101 | N | $43.43 | Ig paraprotein qual bld/ur | Detection of Immunoglobulin paraprotein (M-protein) in blood or urine | Immunoglobulin paraprotein (m-protein), qualitative, immunoprecipitation and mass spectrometry, blood or urine, including isotype | |||
| 2026 | 0080U | 20260101 | N | $3,520.00 | Onc lng 5 clin rsk factr alg | Analysis of galectin-3-binding protein and scavenger receptor cysteine-rich | Oncology (lung), mass spectrometric analysis of galectin-3-binding protein and scavenger receptor cysteine-rich type 1 protein m130, with five clinical risk factors (age, smoking status, nodule diameter, nodule-spiculation status and nodule location), utilizing plasma, algorithm reported as a categorical probability of malignancy | |||
| 2026 | 0082U | 20260101 | N | $246.92 | Rx test def 90+ rx/sbsts ur | Definitive drug testing for 90 or more drugs in urine | Drug test(s), definitive, 90 or more drugs or substances, definitive chromatography with mass spectrometry, and presumptive, any number of drug classes, by instrument chemistry analyzer (utilizing immunoassay), urine, report of presence or absence of each drug, drug metabolite or substance with description and severity of significant interactions per date of service | |||
| 2026 | 0083U | 20260101 | N | $167.35 | Onc rspse chemo cntrst tomog | Evaluation of response to chemotherapy drugs using motility contrast tomography | Oncology, response to chemotherapy drugs using motility contrast tomography, fresh or frozen tissue, reported as likelihood of sensitivity or resistance to drugs or drug combinations | |||
| 2026 | 0084U | 20260101 | N | $720.00 | Rbc dna gnotyp 10 bld groups | DNA red blood cell antigen typing | Red blood cell antigen typing, dna, genotyping of 10 blood groups with phenotype prediction of 37 red blood cell antigens | |||
| 2026 | 0086U | 20260101 | N | $200.00 | Nfct ds bact&fng org id 6+ | FISH identification of organisms in blood culture | Infectious disease (bacterial and fungal), organism identification, blood culture, using rrna fish, 6 or more organism targets, reported as positive or negative with phenotypic minimum inhibitory concentration (mic)-based antimicrobial susceptibility | |||
| 2026 | 0087U | 20260101 | N | $3,159.42 | Crd hrt trnspl mrna 1283 gen | mRNA gene expression profiling of genes in heart transplant biopsy tissue to | Cardiology (heart transplant), mrna gene expression profiling by microarray of 1283 genes, transplant biopsy tissue, allograft rejection and injury algorithm reported as a probability score | |||
| 2026 | 0088U | 20260101 | N | $3,159.42 | Trnsplj kdn algrft rej 1494 | mRNA gene expression profiling of genes in kidney transplant tissue to evaluate | Transplantation medicine (kidney allograft rejection), microarray gene expression profiling of 1494 genes, utilizing transplant biopsy tissue, algorithm reported as a probability score for rejection | |||
| 2026 | 0089U | 20260101 | N | $760.00 | Onc mlnma prame & linc00518 | Gene expression profiling of melanoma in superficial sample collected by | Oncology (melanoma), gene expression profiling by rtqpcr, prame and linc00518, superficial collection using adhesive patch(es) | |||
| 2026 | 0090U | 20260101 | N | $1,950.00 | Onc cutan mlnma mrna 23 gene | mRNA gene expression profiling of 23 genes in skin melanoma tissue sample | Oncology (cutaneous melanoma), mrna gene expression profiling by rt-pcr of 23 genes (14 content and 9 housekeeping), utilizing formalin-fixed paraffin-embedded (ffpe) tissue, algorithm reported as a categorical result (ie, benign, intermediate, malignant) | |||
| 2026 | 0092U | 20260101 | N | $2,488.00 | Onc lng 3 prtn bmrk plsm alg | Measurement of 3 protein biomarkers for lung cancer in plasma | Oncology (lung), three protein biomarkers, immunoassay using magnetic nanosensor technology, plasma, algorithm reported as risk score for likelihood of malignancy | |||
| 2026 | 0093U | 20260101 | N | $62.14 | Rx mntr 65 com drugs urine | Prescription drug monitoring for 65 common drugs in urine | Prescription drug monitoring, evaluation of 65 common drugs by lc-ms/ms, urine, each drug reported detected or not detected | |||
| 2026 | 0094U | 20260101 | N | $7,582.20 | Genome rapid sequence alys | Rapid sequence gene testing | Genome (eg, unexplained constitutional or heritable disorder or syndrome), rapid sequence analysis | |||
| 2026 | 0095U | 20260101 | N | $771.98 | Ee 2 prtn bmrk elisa est | Test for markers of eosinophilic inflammation of esophagus | Eosinophilic esophagitis, 2 protein biomarkers (eotaxin-3 [ccl26 {c-c motif chemokine ligand 26}] and major basic protein [prg2 {proteoglycan 2, pro eosinophil major basic protein}], enzyme-linked immunosorbent assays (elisa), specimen obtained by esophageal string test device, algorithm reported as probability of active or inactive eosinophilic esophagitis | |||
| 2026 | 0096U | 20260101 | N | $35.09 | Hpv hi risk types male urine | Test for detection of high-risk human papillomavirus in male urine | Human papillomavirus (hpv), high-risk types (ie, 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68), male urine | |||
| 2026 | 0101U | 20260101 | N | $1,743.95 | Hered colon ca do 15 genes | Gene sequence analysis panel of 15 genes associated with hereditary colon | Hereditary colon cancer disorders (eg, lynch syndrome, pten hamartoma syndrome, cowden syndrome, familial adenomatosis polyposis), genomic sequence analysis panel utilizing a combination of ngs, sanger, mlpa, and array cgh, with mmrna analytics to resolve variants of unknown significance when indicated (15 genes [sequencing and deletion/duplication], epcam and grem1 [deletion/duplication only]) | |||
| 2026 | 0102U | 20260101 | N | $1,303.95 | Hered brst ca rltd do 17 gen | Gene sequence analysis panel of 17 genes associated with hereditary breast | Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis panel utilizing a combination of ngs, sanger, mlpa, and array cgh, with mmrna analytics to resolve variants of unknown significance when indicated (17 genes [sequencing and deletion/duplication]) | |||
| 2026 | 0103U | 20260101 | N | $1,743.95 | Hered ova ca pnl 24 genes | Gene sequence analysis panel of 24 genes associated with hereditary ovarian | Hereditary ovarian cancer (eg, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis panel utilizing a combination of ngs, sanger, mlpa, and array cgh, with mmrna analytics to resolve variants of unknown significance when indicated (24 genes [sequencing and deletion/duplication], epcam [deletion/duplication only]) | |||
| 2026 | 0105U | 20260101 | N | $950.00 | Neph ckd mult eclia tum nec | Measurement of tumor necrosis factor receptor 1A, receptor superfamily 2 | Nephrology (chronic kidney disease), multiplex electrochemiluminescent immunoassay (eclia) of tumor necrosis factor receptor 1a, receptor superfamily 2 (tnfr1, tnfr2), and kidney injury molecule-1 (kim-1) combined with longitudinal clinical data, including apol1 genotype if available, and plasma (isolated fresh or frozen), algorithm reported as probability score for rapid kidney function decline (rkfd) | |||
| 2026 | 0106U | 20260101 | N | $874.49 | Gstr emptg 7 timed brth spec | Evaluation of gastric emptying by measurement of radiolabeled carbon dioxide in | Gastric emptying, serial collection of 7 timed breath specimens, non-radioisotope carbon-13 (13c) spirulina substrate, analysis of each specimen by gas isotope ratio mass spectrometry, reported as rate of 13co2 excretion | |||
| 2026 | 0107U | 20260101 | N | $16.00 | C diff tox ag detcj ia stool | Antigen test for detection of Clostridium difficile toxin in stool | Clostridium difficile toxin(s) antigen detection by immunoassay technique, stool, qualitative, multiple-step method | |||
| 2026 | 0108U | 20260101 | N | $4,950.00 | Gi barrett esoph 9 prtn bmrk | Computer-assisted digital imaging of esophagus specimen slides to evaluate risk | Gastroenterology (barrett's esophagus), whole slide-digital imaging, including morphometric analysis, computer-assisted quantitative immunolabeling of 9 protein biomarkers (p16, amacr, p53, cd68, cox-2, cd45ro, hif1a, her-2, k20) and morphology, formalin-fixed paraffinembedded tissue, algorithm reported as risk of progression to high-grade dysplasia or cancer | |||
| 2026 | 0109U | 20260101 | N | $142.63 | Id aspergillus dna 4 species | DNA test for detection of 4 Aspergillus species | Infectious disease (aspergillus species), real-time pcr for detection of dna from 4 species (a. fumigatus, a. terreus, a. niger, and a. flavus), blood, lavage fluid, or tissue, qualitative reporting of presence or absence of each species | |||
| 2026 | 0110U | 20260101 | N | $27.11 | Rx mntr 1+oral onc rx&sbsts | Monitoring of anti-cancer drugs in patient blood, serum, or plasma | Prescription drug monitoring, one or more oral oncology drug(s) and substances, definitive tandem mass spectrometry with chromatography, serum or plasma from capillary blood or venous blood, quantitative report with steady-state range for the prescribed drug(s) when detected | |||
| 2026 | 0111U | 20260101 | N | $682.29 | Onc colon ca kras&nras alys | Gene analysis (KRAS and NRAS) in prostate tumor tissue | Oncology (colon cancer), targeted kras (codons 12, 13, and 61) and nras (codons 12, 13, and 61) gene analysis utilizing formalin-fixed paraffin-embedded tissue | |||
| 2026 | 0112U | 20260101 | N | $356.13 | Iadi 16s&18s rrna genes | Gene analysis for detection of infectious agent and drug resistance gene | Infectious agent detection and identification, targeted sequence analysis (16s and 18s rrna genes) with drugresistance gene | |||
| 2026 | 0113U | 20260101 | N | $760.00 | Onc prst8 pca3&tmprss2-erg | Measurement of PCA3 gene in urine and prostate-specific antigen (PSA) in serum | Oncology (prostate), measurement of pca3 and tmprss2-erg in urine and psa in serum following prostatic massage, by rna amplification and fluorescencebased detection, algorithm reported as risk score | |||
| 2026 | 0114U | 20260101 | N | $1,938.01 | Gi barretts esoph vim&ccna1 | Gene analysis (VIM and CCNA1 methylation) in esophageal cells to evaluate | Gastroenterology (barrett's esophagus), vim and ccna1 methylation analysis, esophageal cells, algorithm reported as likelihood for barrett's esophagus | |||
| 2026 | 0115U | 20260101 | N | $275.35 | Respir iadna 18 viral&2 bact | Respiratory infectious agent detection by nucleic acid (DNA and RNA), 18 viral | Respiratory infectious agent detection by nucleic acid (dna and rna), 18 viral types and subtypes and 2 bacterial targets, amplified probe technique, including multiplex reverse transcription for rna targets, each analyte reported as detected or not detected | |||
| 2026 | 0116U | 20260101 | N | $246.92 | Rx mntr nzm ia 35+oral flu | Analysis of 35 or more drugs in mouth fluid to evaluate risk of prescription | Prescription drug monitoring, enzyme immunoassay of 35 or more drugs confirmed with lc-ms/ms, oral fluid, algorithm results reported as a patientcompliance measurement with risk of drug to drug interactions for prescribed medications | |||
| 2026 | 0117U | 20260101 | N | $840.65 | Pain mgmt 11 endogenous anal | Analysis of 11 biochemical substances in urine to evaluate likelihood of | Pain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmalonate, 3hydroxypropyl mercapturic acid (3-hpma), quinolinic acid, kynurenic acid), lcms/ms, urine, algorithm reported as a pain-index score with likelihood of atypical biochemical function associated with pain | |||
| 2026 | 0118U | 20260101 | N | $2,753.25 | Trnsplj don-drv cll-fr dna | Measurement of transplant donor cell-free DNA in transplant recipient plasma | Transplantation medicine, quantification of donor-derived cell-free dna using whole genome next-generation sequencing, plasma, reported as percentage of donorderived cell-free dna in the total cell-free dna | |||
| 2026 | 0119U | 20260101 | N | $83.76 | Crd ceramides liq chrom plsm | Measurement of ceramides for assessment of heart disease risk | Cardiology, ceramides by liquid chromatography-tandem mass spectrometry, plasma, quantitative report with risk score for major cardiovascular events | |||
| 2026 | 0120U | 20260101 | N | $2,510.21 | Onc b cll lymphm mrna 58 gen | mRNA, gene expression profiling of 58 genes in tissue sample for B-cell | Oncology (b-cell lymphoma classification), mrna, gene expression profiling by fluorescent probe hybridization of 58 genes (45 content and 13 housekeeping genes), formalin-fixed paraffin-embedded tissue, algorithm reported as likelihood for primary mediastinal b-cell lymphoma (pmbcl) and diffuse large b-cell lymphoma (dlbcl) with cell of origin subtyping in the latter | |||
| 2026 | 0121U | 20260101 | N | $509.20 | Sc dis vcam-1 whole blood | Blood test for sickle cells using VCAM-1 | Sickle cell disease, microfluidic flow adhesion (vcam-1), whole blood | |||
| 2026 | 0122U | 20260101 | N | $526.23 | Sc dis p-selectin whl blood | Blood test for sickle cells using P-Selectin | Sickle cell disease, microfluidic flow adhesion (p-selectin), whole blood | |||
| 2026 | 0123U | 20260101 | N | $357.63 | Mchnl fragility rbc prflg | Test for fragility of red blood cells | Mechanical fragility, rbc, shear stress and spectral analysis profiling | |||
| 2026 | 0129U | 20260101 | N | $1,303.95 | Hered brst ca rltd do panel | Gene analysis of genes associated with hereditary breast cancer and related | Hereditary breast cancer-related disorders (eg, hereditary breast cancer, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis and deletion/duplication analysis panel (atm, brca1, brca2, cdh1, chek2, palb2, pten, and tp53) | |||
| 2026 | 0130U | 20260101 | N | $584.90 | Hered colon ca do mrna pnl | Targeted mRNA sequence analysis of genes associated with hereditary colon | Hereditary colon cancer disorders (eg, lynch syndrome, pten hamartoma syndrome, cowden syndrome, familial adenomatosis polyposis), targeted mrna sequence analysis panel (apc, cdh1, chek2, mlh1, msh2, msh6, mutyh, pms2, pten, and tp53) (list separately in addition to code for primary procedure) | |||
| 2026 | 0133U | 20260101 | N | $690.29 | Hered prst8 ca rltd do 11 | Targeted mRNA sequence analysis of 11 genes associated with hereditary prostate | Hereditary prostate cancer-related disorders, targeted mrna sequence analysis panel (11 genes) (list separately in addition to code for primary procedure) | |||
| 2026 | 0134U | 20260101 | N | $748.39 | Hered pan ca mrna pnl 18 gen | Targeted mRNA sequence analysis of 18 genes associated with hereditary pan | Hereditary pan cancer (eg, hereditary breast and ovarian cancer, hereditary endometrial cancer, hereditary colorectal cancer), targeted mrna sequence analysis panel (18 genes) (list separately in addition to code for primary procedure) | |||
| 2026 | 0136U | 20260101 | N | $407.43 | Atm mrna seq alys | mRNA gene analysis (ataxia telangiectasia mutated) | Atm (ataxia telangiectasia mutated) (eg, ataxia telangiectasia) mrna sequence analysis (list separately in addition to code for primary procedure) | |||
| 2026 | 0137U | 20260101 | N | $282.88 | Palb2 mrna seq alys | mRNA gene analysis (partner and localizer of BRCA2) | Palb2 (partner and localizer of brca2) (eg, breast and pancreatic cancer) mrna sequence analysis (list separately in addition to code for primary procedure) | |||
| 2026 | 0138U | 20260101 | N | $468.33 | Brca1 brca2 mrna seq alys | mRNA gene analysis (BRCA1, DNA repair associated and BRCA2, DNA repair | Brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) (eg, hereditary breast and ovarian cancer) mrna sequence analysis (list separately in addition to code for primary procedure) | |||
| 2026 | 0140U | 20260101 | N | $156.75 | Nfct ds fungi dna 15 trgt | Amplifed DNA probe detection of fungus in blood culture specimen | Infectious disease (fungi), fungal pathogen identification, dna (15 fungal targets), blood culture, amplified probe technique, each target reported as detected or not detected | |||
| 2026 | 0141U | 20260101 | N | $156.75 | Nfct ds bact&fng gram pos | Amplifed DNA probe detection of 20 gram-positive bacterial targets, 4 | Infectious disease (bacteria and fungi), gram-positive organism identification and drug resistance element detection, dna (20 gram-positive bacterial targets, 4 resistance genes, 1 pan gram-negative bacterial target, 1 pan candida target), blood culture, amplified probe technique, each target reported as detected or not detected | |||
| 2026 | 0142U | 20260101 | N | $156.75 | Nfct ds bact&fng gram neg | Amplifed DNA probe detection of 20 gram-positive bacterial targets, 6 | Infectious disease (bacteria and fungi), gram-negative bacterial identification and drug resistance element detection, dna (21 gram-negative bacterial targets, 6 resistance genes, 1 pan gram-positive bacterial target, 1 pan candida target), amplified probe technique, each target reported as detected or not detected | |||
| 2026 | 0152U | 20260101 | N | $2,126.20 | Nfct ds dna untrgt ngnrj seq | Cell-free DNA sequencing of disease-causing organisms in plasma specimen, with | Infectious disease (bacteria, fungi, parasites, and dna viruses), microbial cell-free dna, plasma, untargeted next-generation sequencing, report for significant positive pathogens | |||
| 2026 | 0153U | 20260101 | N | $3,159.42 | Onc breast mrna 101 genes | mRNA gene expression profiling of 101 genes in breast growth tissue specimen | Oncology (breast), mrna, gene expression profiling by next-generation sequencing of 101 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as a triple negative breast cancer clinical subtype(s) with information on immune cell involvement | |||
| 2026 | 0154U | 20260101 | N | $482.14 | Onc urthl ca rna fgfr3 gene | RNA gene analysis for detection of fibroblast growth factor receptor 3 gene | Oncology (urothelial cancer), rna,analysis by real-time rt-pcr of the fgfr3 (fibroblast growth factor receptor 3) gene analysis (ie, p.r248c [c.742c>t], p.s249c [c.746c>g], p.g370c [c.1108g>t], p.y373c [c.1118a>g], fgfr3-tacc3v1, and fgfr3-tacc3v3) utilizing formalin-fixed paraffin-embedded urothelial cancer tumor tissue, reported as fgfr gene alteration status | |||
| 2026 | 0155U | 20260101 | N | $274.83 | Onc brst ca dna pik3ca gene | DNA analysis for detection of PIK3CA gene mutation in breast growth tissue | Oncology (breast cancer), dna, pik3ca (phosphatidylinositol-4,5bisphosphate 3-kinase, catalytic subunit alpha) (eg, breast cancer) gene analysis (ie, p.c420r, p.e542k, p.e545a, p.e545d [g.1635g>t only], p.e545g, p.e545k, p.q546e, p.q546r, p.h1047l, p.h1047r, p.h1047y), utilizing formalin-fixed paraffin-embedded breast tumor tissue, reported as pik3ca gene mutation status | |||
| 2026 | 0156U | 20260101 | N | $1,740.00 | Copy number sequence alys | Gene analysis copy number sequence analysis | Copy number (eg, intellectual disability, dysmorphology), sequence analysis | |||
| 2026 | 0157U | 20260101 | N | $282.88 | Apc mrna seq alys | mRNA gene analysis of APC regulator of WNT signaling pathway | Apc (apc regulator of wnt signaling pathway) (eg, familial adenomatosis polyposis [fap]) mrna sequence analysis (list separately in addition to code for primary procedure) | |||
| 2026 | 0158U | 20260101 | N | $282.88 | Mlh1 mrna seq alys | mRNA gene analysis of mutL homolog 1 | Mlh1 (mutl homolog 1) (eg, hereditary non-polyposis colorectal cancer, lynch syndrome) mrna sequence analysis (list separately in addition to code for primary procedure) | |||
| 2026 | 0159U | 20260101 | N | $282.88 | Msh2 mrna seq alys | mRNA gene analysis of mutS homolog 2 | Msh2 (muts homolog 2) (eg, hereditary colon cancer, lynch syndrome) mrna sequence analysis (list separately in addition to code for primary procedure) | |||
| 2026 | 0160U | 20260101 | N | $282.88 | Msh6 mrna seq alys | mRNA gene analysis of mutS homolog 6 | Msh6 (muts homolog 6) (eg, hereditary colon cancer, lynch syndrome) mrna sequence analysis (list separately in addition to code for primary procedure) | |||
| 2026 | 0161U | 20260101 | N | $282.88 | Pms2 mrna seq alys | mRNA gene analysis of PMS1 homolog 2, mismatch repair system component | Pms2 (pms1 homolog 2, mismatch repair system component) (eg, hereditary nonpolyposis colorectal cancer, lynch syndrome) mrna sequence analysis (list separately in addition to code for primary procedure) | |||
| 2026 | 0162U | 20260101 | N | $486.54 | Hered colon ca trgt mrna pnl | Targeted mRNA sequence analysis for genes associated with hereditary colon | Hereditary colon cancer (lynch syndrome), targeted mrna sequence analysis panel (mlh1, msh2, msh6, pms2) (list separately in addition to code for primary procedure) | |||
| 2026 | 0163U | 20260101 | N | $390.75 | Onc clrct scr 3 prtn alg | Screening test for 3 protein biomarkers of colorectal cancer in serum or plasma | Oncology (colorectal) screening, biochemical enzyme-linked immunosorbent assay (elisa) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [tdgf-1, cripto- 1], carcinoembryonic antigen [cea], extracellular matrix protein [ecm]), with demographic data (age, gender, crc-screening compliance) using a proprietary algorithm and reported as likelihood of crc or advanced adenomas | |||
| 2026 | 0164U | 20260101 | N | $112.02 | Gi ibs ia anti-cdtb&vinculin | Test for detection of antibodies associated with irritable bowel syndrome in | Gastroenterology (irritable bowel syndrome [ibs]), immunoassay for anti-cdtb and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results | |||
| 2026 | 0165U | 20260101 | N | $463.76 | Peanut allg asmt epi | Test for detection of antigens associated with peanut allergy in blood | Peanut allergen-specific quantitative assessment of multiple epitopes using enzyme-linked immunosorbent assay (elisa), blood, individual epitope results and probability of peanut allergy | |||
| 2026 | 0166U | 20260101 | N | $503.40 | Liver ds 10 biochem asy srm | Liver disease test panel in serum specimen | Liver disease, 10 biochemical assays (a2-macroglobulin, haptoglobin, apolipoprotein a1, bilirubin, ggt, alt, ast, triglycerides, cholesterol, fasting glucose) and biometric and demographic data, utilizing serum, algorithm reported as scores for fibrosis, necroinflammatory activity, and steatosis with a summary interpretation | |||
| 2026 | 0169U | 20260101 | N | $466.17 | Nudt15&tpmt gene com vrnt | Gene analysis (nudix hydrolase 15) and TPMT (thiopurine S-methyltransferase) | Nudt15 (nudix hydrolase 15) and tpmt (thiopurine s-methyltransferase) (eg, drug metabolism) gene analysis, common variants | |||
| 2026 | 0170U | 20260101 | N | $1,950.00 | Neuro asd rna next gen seq | RNA gene sequencing for probability of autism spectrum disorder in saliva | Neurology (autism spectrum disorder [asd]), rna, next-generation sequencing, saliva, algorithmic analysis, and results reported as predictive probability of asd diagnosis | |||
| 2026 | 0171U | 20260101 | N | $1,519.06 | Trgt gen seq alys pnl dna 23 | DNA analysis of targeted sequences in 23 genes for detection of abnormalites | Targeted genomic sequence analysis panel, acute myeloid leukemia, myelodysplastic syndrome, and myeloproliferative neoplasms, dna analysis, 23 genes, interrogation for sequence variants, rearrangements and minimal residual disease, reported as presence/absence | |||
| 2026 | 0172U | 20260101 | N | $3,030.00 | Onc sld tum alys brca1 brca2 | DNA gene analysis (BRCA1, DNA repair associated and BRCA2, DNA repair | Oncology (solid tumor as indicated by the label), somatic mutation analysis of brca1 (brca1, dna repair associated), brca2 (brca2, dna repair associated) and analysis of homologous recombination deficiency pathways, dna, formalin-fixed paraffin-embedded tissue, algorithm quantifying tumor genomic instability score | |||
| 2026 | 0173U | 20260101 | N | $466.17 | Psyc gen alys panel 14 genes | Gene analysis panel for detection of variants in 14 genes associated with | Psychiatry (ie, depression, anxiety), genomic analysis panel, includes variant analysis of 14 genes | |||
| 2026 | 0174U | 20260101 | N | $1,305.37 | Onc solid tumor 30 prtn trgt | Mass spectrometry testing for 30 protein targets in tissue specimen to predict | Oncology (solid tumor), mass spectrometric 30 protein targets, formalin-fixed paraffin-embedded tissue, prognostic and predictive algorithm reported as likely, unlikely, or uncertain benefit of 39 chemotherapy and targeted therapeutic oncology agents | |||
| 2026 | 0175U | 20260101 | N | $1,336.09 | Psyc gen alys panel 15 genes | Gene analysis panel for detection of variants in 15 genes associated with | Psychiatry (eg, depression, anxiety), genomic analysis panel, variant analysis of 15 genes | |||
| 2026 | 0176U | 20260101 | N | $64.19 | Cdtb&vinculin igg antb ia | Test for detection of IgG antibodies associated with irritable bowel syndrome | Cytolethal distending toxin b (cdtb) and vinculin igg antibodies by immunoassay (ie, elisa) | |||
| 2026 | 0177U | 20260101 | N | $274.83 | Onc brst ca dna pik3ca 11 | DNA gene analysis (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic | Oncology (breast cancer), dna, pik3ca (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha) gene analysis of 11 gene variants utilizing plasma, reported as pik3ca gene mutation status | |||
| 2026 | 0178U | 20260101 | N | $459.86 | Peanut allg asmt epi clin rx | Test for detection of antigens associated with peanut allergy in blood | Peanut allergen-specific quantitative assessment of multiple epitopes using enzyme-linked immunosorbent assay (elisa), blood, report of minimum eliciting exposure for a clinical reaction |
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