CPT code 0447U: Cytokine assay, eleven plasma biomarkers2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This plasma immunoassay measures 11 cytokine biomarkers and reports an algorithmic risk score for clinical flare in systemic lupus erythematosus.
Medicare pays $840.65 for 0447U 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
$840.65
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2025
- 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 0447U covers
0447U identifies an immunoassay of 11 soluble cytokine mediators in plasma for people with systemic lupus erythematosus (SLE). The test reports the individual biomarker results together with an algorithmic prognostic risk score for developing a clinical flare. It is a specialized laboratory assay used to assess flare risk, rather than a general cytokine measurement or routine SLE antibody test.
Report 0447U for the defined 11-biomarker assay and its associated score. Medicare pays the code through the Clinical Laboratory Fee Schedule (CLFS), with one national amount across states and localities and no office-versus-facility difference. The 2026 national CLFS amount is $840.65, unchanged from 2025. The code is paid only from 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 0447U
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 0447U. 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 0447U: Medicare pays the test only from the CLFS.
0447U on the lab fee schedule since 2024
0447U · CLFS 2026 Q4 (current)
$840.65
Unchanged since Jan 1, 2025
Every change on file
- Jan 1, 2025 · CLFS 2025 Q1MAC-priced → $840.65
11 quarterly CLFS releases on file, first CLFS 2024 Q2. A code missing from a quarter wasn’t on that release.
0447U compared with similar tests
- 0446ULupus cytokine assayTen biomarkers, plasma$840.65
- 0446U analyzes 10 cytokine biomarkers for SLE, while 0447U analyzes 11. Choose according to the assay performed.
- 86225DNA antibodyDouble-stranded DNA$13.74
- 86225 reports anti-double-stranded DNA antibody testing; 0447U measures cytokine mediators and provides an algorithmic SLE flare-risk score.
- 86160Complement antigenEach component$12.00
- 86160 is complement testing, not a cytokine assay. It does not represent the 11-biomarker analysis and prognostic score reported with 0447U.
- 86038ANA testScreening$12.09
- 86038 is antinuclear antibody testing. It addresses a different laboratory question from the cytokine-based flare-risk assessment in 0447U.
0447U billing questions
How is 0447U different from 0446U?
0447U analyzes 11 soluble mediator biomarkers, while 0446U is the 10-biomarker SLE cytokine assay sibling. Select the code that matches the assay performed.
What specimen does 0447U use?
The assay uses plasma and reports 11 cytokine soluble mediator biomarkers with an algorithmic flare-risk score.
How does the biomarker count affect code selection?
Choose the code that matches the assay performed: 0447U is the 11-biomarker assay, while 0446U is the 10-biomarker sibling.
How does Medicare pay 0447U?
Medicare pays 0447U through the CLFS at one national amount across states and localities, with no 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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