CPT code 0205U: Genetic AMD test, three variants, buccal swab2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This assay detects three genetic variants from a buccal swab and reports neovascular age-related macular degeneration risk associated with zinc supplementation.
Medicare pays $47.00 for 0205U 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
$47.00
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2021
- 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 0205U covers
0205U analyzes three genetic variants—two in CFH and one in ARMS2—from a buccal, or cheek, swab. The laboratory uses PCR and MALDI-TOF and reports a positive or negative result for neovascular age-related macular degeneration risk associated with zinc supplements. This is a genetic risk assay, not a retinal imaging or disease-activity test.
Report 0205U for this assay performed on a buccal-swab specimen. Medicare pays the code through the CLFS at one national amount in every state and locality, without geographic or office/facility adjustment. The 2026 national CLFS amount is $47.00, unchanged from 2021 through 2026. The code is paid through the CLFS only, with no physician fee schedule payment.
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 0205U
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 0205U. 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 0205U: Medicare pays the test only from the CLFS.
0205U on the lab fee schedule since 2020
0205U · CLFS 2026 Q4 (current)
$47.00
Unchanged since Jan 1, 2021
Every change on file
- Jan 1, 2021 · CLFS 2021 Q1MAC-priced → $47.00
25 quarterly CLFS releases on file, first CLFS 2020 Q4. A code missing from a quarter wasn’t on that release.
0205U compared with similar tests
- 92134Retinal OCTPosterior segment, retina$29.35–$43.16
- 92134 describes retinal imaging by optical coherence tomography. It evaluates retinal structure; 0205U analyzes genetic variants from a buccal swab.
- 92235Fluorescein angiographyMultiframe retinal imaging$142.65–$225.38
- 92235 describes retinal fluorescein angiography. It is an imaging procedure, whereas 0205U is a laboratory genetic assay.
0205U billing questions
How is 0205U different from retinal imaging?
0205U analyzes genetic variants from a buccal swab and reports a risk result. Retinal imaging codes describe imaging services, not this molecular assay.
What specimen does the assay use?
The assay uses a cheek-cell, or buccal, swab specimen.
What result does the laboratory report?
The laboratory reports a positive or negative result for neovascular age-related macular degeneration risk associated with zinc supplements.
Is physician interpretation separately payable?
0205U is paid through the CLFS only and has no physician fee schedule payment.
How does Medicare price 0205U?
Medicare uses one national CLFS amount across states and localities, without an office or facility adjustment.
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
Fee sheets · Coming soon
Put 0205U and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist