CPT code 0410U: Pancreatic assay, whole genome, blood or plasma2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This proprietary laboratory assay uses whole genome sequencing of whole blood or plasma DNA to report pancreatic cancer as detected or not detected.
Medicare pays $1,160.00 for 0410U 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
$1,160.00
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2024
- 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 0410U covers
0410U identifies a proprietary oncology laboratory analysis of DNA obtained from whole blood or plasma. The laboratory uses whole genome sequencing with 5-hydroxymethylcytosine enrichment, then applies an algorithm to report pancreatic cancer as detected or not detected. The result communicates detection status rather than a numeric measurement. The code identifies this pancreatic assay and its whole-blood or plasma testing approach.
Report 0410U for the assay. Medicare pays the code through the CLFS at one national amount applied in every state and locality, with no geographic adjustment or office-versus-facility difference. The 2026 national CLFS amount is $1,160.00, unchanged in 2024, 2025, and 2026. Payment is through the CLFS only; no separate physician fee schedule payment is associated with this code.
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 0410U
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 0410U. 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 0410U: Medicare pays the test only from the CLFS.
0410U on the lab fee schedule since 2023
0410U · CLFS 2026 Q4 (current)
$1,160.00
Unchanged since Jan 1, 2024
Every change on file
- Jan 1, 2024 · CLFS 2024 Q1MAC-priced → $1,160.00
13 quarterly CLFS releases on file, first CLFS 2023 Q4. A code missing from a quarter wasn’t on that release.
0410U compared with similar tests
- 86301CA 19-9Quantitative tumor antigen$20.81
- 86301 measures the CA 19-9 tumor marker. 0410U uses whole genome sequencing of whole-blood or plasma DNA and reports pancreatic cancer as detected or not detected.
- 81455Tumor genomic panel51+ genes, DNA or DNA/RNA$2,919.60
- 81455 is used for genomic sequencing to characterize a neoplasm. 0410U is the pancreatic cancer assay using whole-blood or plasma DNA and a detected-or-not-detected result.
0410U billing questions
Which specimens does this assay use?
The assay analyzes DNA from whole blood or plasma.
What method does 0410U use?
It uses whole genome sequencing with 5-hydroxymethylcytosine enrichment.
What result does the assay report?
Its algorithm reports pancreatic cancer as detected or not detected.
How does Medicare pay for 0410U?
Medicare pays the code through the CLFS at one national amount that applies across states and localities, without an office or facility difference.
Is there a separate physician fee schedule payment?
No. The code is paid only through 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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