CPT code 0477U: Psychiatric pharmacogenomics, 14 genes plus CYP2D6 copy number2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This psychiatric medication panel analyzes 14 genes and CYP2D6 copy number to report gene-drug interactions and phenotypes for treatment planning.
Medicare pays $416.78 for 0477U 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
$416.78
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 0477U covers
This pharmacogenomic assay evaluates how genetic variation may affect psychiatric medication response. It analyzes 14 genes, includes CYP2D6 copy-number variant analysis, and reports gene-drug interactions and phenotypes. It is used in medication management for major depressive disorder, generalized anxiety disorder, ADHD, and schizophrenia. Specimens include whole blood and buccal swabs. Psychiatrists and other clinicians managing medication treatment may order the assay, with testing performed by a clinical laboratory.
Report 0477U for the panel service. Medicare pays the test under the CLFS, with one national amount across localities and no office-versus-facility difference. The 2026 national CLFS amount is $416.78, unchanged from 2025. The code is paid only from the CLFS, with no separate physician fee schedule payment for interpretation.
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 0477U
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 0477U. 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 0477U: Medicare pays the test only from the CLFS.
0477U on the lab fee schedule since 2024
0477U · CLFS 2026 Q4 (current)
$416.78
Unchanged since Jan 1, 2025
Every change on file
- Jan 1, 2025 · CLFS 2025 Q1MAC-priced → $416.78
9 quarterly CLFS releases on file, first CLFS 2024 Q4. A code missing from a quarter wasn’t on that release.
0477U compared with similar tests
- 0476UPsychiatric PGx14 genes, CYP2D6 copy number$416.78
- Both describe psychiatric medication pharmacogenomic testing involving 14 genes and CYP2D6. 0477U specifically includes CYP2D6 copy-number variant analysis.
- 81226CYP2D6 testingCommon CYP2D6 variants$450.91
- 81226 is focused CYP2D6 genotyping. Use 0477U for the broader psychiatric panel when the assay includes the 14-gene analysis and CYP2D6 copy-number assessment.
- 81225CYP2C19 testCommon variants$291.36
- 81225 is focused CYP2C19 genotyping, rather than the broader psychiatric panel reported with 0477U.
0477U billing questions
How is 0477U distinguished from 0476U?
0477U specifically includes CYP2D6 copy-number variant analysis in the 14-gene psychiatric pharmacogenomic panel. Match the code to the assay and results actually reported.
Which specimens are used?
The assay is described for whole blood or a buccal swab.
Are the 14 genes billed separately?
The reported service is the 0477U assay, which includes the 14-gene analysis and CYP2D6 copy-number assessment.
Can a separate modifier 26 interpretation be billed?
The code is paid through the CLFS and has no separate physician fee schedule payment for interpretation.
Does Medicare pay the same amount in every locality?
Yes. The CLFS amount is national and does not vary by locality or by office versus facility setting.
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
Fee sheets · Coming soon
Put 0477U and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist