CPT code 0471U: KRAS/NRAS test, 35 variants in tissue2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Qualitative tissue testing identifies detected KRAS and NRAS variants across a 35-variant assay used in colorectal cancer predictive assessment.
Medicare pays $760.00 for 0471U 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
$760.00
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 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 0471U covers
0471U identifies a qualitative real-time PCR assay for 35 KRAS and NRAS variants in colorectal cancer tissue. The assay uses formalin-fixed, paraffin-embedded tissue and examines variants across exons 2, 3, and 4. It reports which mutations are detected, supporting predictive assessment in colorectal cancer. The combined gene scope distinguishes this service from tests limited to KRAS or NRAS alone.
Report 0471U when the laboratory performs this specified combined assay. Medicare pays the code through the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $760.00, unchanged from 2025. One national amount applies across states and localities, with no geographic or office-versus-facility adjustment. The code is paid only 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 0471U
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 0471U. 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 0471U: Medicare pays the test only from the CLFS.
0471U on the lab fee schedule since 2024
0471U · CLFS 2026 Q4 (current)
$760.00
Unchanged since Jan 1, 2025
Every change on file
- Jan 1, 2025 · CLFS 2025 Q1MAC-priced → $760.00
10 quarterly CLFS releases on file, first CLFS 2024 Q3. A code missing from a quarter wasn’t on that release.
0471U compared with similar tests
- 81275KRAS testingExon 2 variants$193.25
- 81275 describes KRAS exon 2 testing. 0471U is the combined colorectal cancer assay for 35 KRAS and NRAS variants in tissue.
- 81276KRAS testingBeyond exon 2$193.25
- 81276 describes KRAS testing across exons 2, 3, and 4. Choose 0471U when the laboratory performs the combined 35-variant KRAS/NRAS assay.
- 81311NRAS variant testExons 2 and 3$295.79
- 81311 describes NRAS testing across exons 2, 3, and 4. It is gene-specific, unlike 0471U's combined KRAS/NRAS assay.
0471U billing questions
When should 0471U be chosen over a KRAS- or NRAS-only test?
Use 0471U when the laboratory performs the specified combined assay for 35 KRAS and NRAS variants in colorectal cancer tissue. A test limited to one gene has a different testing scope.
What specimen and method does 0471U describe?
The assay uses formalin-fixed, paraffin-embedded colorectal cancer tissue and qualitative real-time PCR.
What result does the assay report?
The qualitative result identifies detected mutations among the 35 KRAS and NRAS variants tested.
Does modifier 26 apply to 0471U?
Medicare pays 0471U through the CLFS; the code is not paid as a separate physician-fee-schedule interpretation service.
Does Medicare payment vary by location or setting?
No. One national CLFS amount applies across states and 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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