CPT code 0209U: Genome analysis, constitutional chromosome abnormalities2026 Medicare lab fee · Clinical Laboratory Fee Schedule
0209U identifies a proprietary whole-genome cytogenomic analysis used to assess constitutional chromosome abnormalities, including copy-number changes, structural changes, and homozygosity.
Medicare pays $787.15 for 0209U 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
$787.15
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 8 sections
What 0209U covers
0209U identifies a proprietary cytogenomic analysis of the whole genome for constitutional chromosome abnormalities. The assay interrogates genomic regions for copy-number changes, structural changes, and areas of homozygosity. It is a genome-wide assessment of chromosomal findings, not a general code for every chromosome study or microarray. The testing laboratory reports this code when it performs the specific assay; the analysis concerns constitutional rather than acquired chromosomal abnormalities.
Medicare pays 0209U under the CLFS at one national amount in every state and locality, with no geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $787.15, unchanged from 2022 through 2026. The code is paid only under the CLFS, with no physician fee schedule payment for 0209U.
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 0209U
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 0209U. 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 0209U: Medicare pays the test only from the CLFS.
0209U on the lab fee schedule since 2020
0209U · CLFS 2026 Q4 (current)
$787.15
Unchanged since Jan 1, 2022
Every change on file
- Jan 1, 2022 · CLFS 2022 Q1MAC-priced → $787.15
25 quarterly CLFS releases on file, first CLFS 2020 Q4. A code missing from a quarter wasn’t on that release.
0209U compared with similar tests
- 81228Chromosomal microarrayCGH copy-number analysis$900.00
- 81228 is used for constitutional genome-wide copy-number analysis by microarray. Use 0209U when the proprietary whole-genome assay described by that code is performed.
- 81229Chromosomal microarrayCopy number and SNP analysis$1,160.00
- 81229 is a constitutional cytogenomic microarray code that includes SNP analysis. 0209U describes an assay that also interrogates structural changes and areas of homozygosity.
- 88262Chromosome analysis15–20 cells, two karyotypes$125.49
- 88262 represents conventional chromosome analysis. 0209U describes a proprietary genome-wide cytogenomic analysis.
0209U billing questions
How does 0209U differ from 81228?
0209U describes a proprietary whole-genome cytogenomic analysis that assesses copy-number changes, structural changes, and homozygosity. 81228 is used for constitutional genome-wide copy-number analysis by microarray; select the code matching the test performed.
How does 0209U differ from 81229?
81229 is a constitutional cytogenomic microarray code that includes SNP analysis. 0209U describes a proprietary assay that also interrogates structural changes and areas of homozygosity.
Is 0209U the code for conventional chromosome analysis?
No. 0209U identifies a genome-wide cytogenomic analysis; 88262 represents conventional chromosome analysis.
Does Medicare apply a local rate to 0209U?
No. Medicare pays one national CLFS amount in every state and locality, with no office-versus-facility adjustment.
Is there a physician fee schedule payment for 0209U?
No. 0209U is paid only under the CLFS.
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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