CPT code 0174U: Tumor protein assay, 30 targets by mass spectrometry2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Mass spectrometry assessment of 30 proteins in solid-tumor tissue supports an algorithmic estimate of likely, unlikely, or uncertain benefit from oncology agents.
Medicare pays $1,305.37 for 0174U under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$1,305.37
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2022
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 7 sections
What 0174U covers
This proprietary laboratory assay uses mass spectrometry to assess 30 protein targets in formalin-fixed, paraffin-embedded solid-tumor tissue. An algorithm combines the results into a prediction of likely, unlikely, or uncertain benefit from 39 chemotherapy and targeted oncology agents. The test links tumor tissue analysis with predicted benefit categories across these treatment options. Oncologists may use the report when considering treatment options for a patient with a solid tumor.
Medicare pays the code through the Clinical Laboratory Fee Schedule (CLFS) only; the code has no physician fee schedule payment row. The 2026 national CLFS amount is $1,305.37, unchanged from 2022 through 2026. The CLFS amount is the same across states and localities, with no office-versus-facility difference.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 0174U
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 0174U. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Not on the physician fee schedule
The physician fee schedule doesn’t list 0174U: Medicare pays the test only from the CLFS.
0174U on the lab fee schedule since 2020
0174U · CLFS 2026 Q4 (current)
$1,305.37
Unchanged since Jan 1, 2022
Every change on file
- Jan 1, 2022 · CLFS 2022 Q1MAC-priced → $1,305.37
26 quarterly CLFS releases on file, first CLFS 2020 Q3. A code missing from a quarter wasn’t on that release.
0174U compared with similar tests
- 0172UTumor gene assayBRCA1/2 and genomic instability$3,030.00
- 0172U focuses on BRCA1 and BRCA2 in solid tumors. 0174U assesses 30 tissue protein targets and reports an algorithmic treatment-benefit prediction.
- 0177UPIK3CA testPlasma, 11 variants$274.83
- 0177U is a breast-cancer DNA analysis focused on PIK3CA. 0174U is a mass-spectrometry assay of 30 proteins in solid-tumor tissue.
- 0179ULung cancer panel23-gene cfDNA analysis$1,943.21
- 0179U is an analysis for non-small-cell lung cancer. 0174U is the 30-protein mass-spectrometry assay with an algorithmic prediction for oncology agents.
0174U billing questions
What tissue is tested?
The assay uses formalin-fixed, paraffin-embedded solid-tumor tissue.
What result does the laboratory report?
An algorithmic prediction of likely, unlikely, or uncertain benefit from 39 chemotherapy and targeted oncology agents.
How does this differ from 0172U?
0172U is a solid-tumor analysis centered on BRCA1 and BRCA2; 0174U assesses 30 protein targets by mass spectrometry.
Is physician interpretation separately paid under this code?
This code has no physician fee schedule payment row; Medicare pays it through the CLFS.
How does Medicare set payment for this code?
CMS sets one national CLFS amount that applies across states and localities, without an office-versus-facility difference.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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