CPT code 0211U: Tumor sequencing, DNA and RNA with therapy associations2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This pan-tumor DNA-and-RNA sequencing service analyzes formalin-fixed tumor tissue and reports interpreted findings with therapy associations.
Medicare pays $8,455.00 for 0211U 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
$8,455.00
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 8 sections
What 0211U covers
0211U represents pan-tumor next-generation sequencing of DNA and RNA from formalin-fixed, paraffin-embedded tumor tissue. The laboratory report interprets single-nucleotide variants, copy-number alterations, tumor mutational burden, and microsatellite instability, and associates findings with therapies. The analysis provides molecular profiling across tumor types.
Report 0211U for the specified analysis and interpretive report. Medicare pays it under the Clinical Laboratory Fee Schedule (CLFS) at one national amount per code that applies in every state and locality, without geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $8,455.00, unchanged from 2021 through 2026. Payment is through the CLFS.
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 0211U
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 0211U. 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 0211U: Medicare pays the test only from the CLFS.
0211U on the lab fee schedule since 2020
0211U · CLFS 2026 Q4 (current)
$8,455.00
Unchanged since Jan 1, 2021
Every change on file
- Jan 1, 2021 · CLFS 2021 Q1MAC-priced → $8,455.00
25 quarterly CLFS releases on file, first CLFS 2020 Q4. A code missing from a quarter wasn’t on that release.
0211U compared with similar tests
- 81445Tumor gene panel5–50 genes, DNA or DNA/RNA$597.91
- 81445 describes a solid-organ tumor sequencing panel in the 5–50-gene range. 0211U identifies the specified pan-tumor DNA-and-RNA analysis and interpretive report.
- 81455Tumor genomic panel51+ genes, DNA or DNA/RNA$2,919.60
- 81455 describes a solid-organ tumor sequencing panel with 51 or more genes. 0211U identifies a specific DNA-and-RNA tumor analysis with therapy associations rather than selecting the service by gene-count range.
- 81479Molecular pathologyUnlisted procedureNo national amount
- 81479 is an unlisted molecular pathology code for a service without a more specific code. Use 0211U when the performed analysis matches its defined service.
0211U billing questions
Which specimen is used?
The analysis uses formalin-fixed, paraffin-embedded tumor tissue.
What findings does the report cover?
It interprets single-nucleotide variants, copy-number alterations, tumor mutational burden, and microsatellite instability, with therapy associations.
How does this differ from 81445?
81445 describes a solid-organ tumor sequencing panel in the 5–50-gene range. Choose based on the service performed; 0211U identifies the specified pan-tumor DNA-and-RNA analysis and interpretive report.
How does this differ from 81455?
81455 describes a solid-organ tumor sequencing panel with 51 or more genes. 0211U identifies a specific pan-tumor DNA-and-RNA analysis with therapy associations.
How does Medicare pay for 0211U?
Medicare pays the code under the CLFS using one national amount across localities, with no office-versus-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
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