CPT code 0481U: CNS tumor sequencing, IDH1, IDH2, and TERT promoter2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Next-generation sequencing of IDH1, IDH2, and the TERT promoter supports molecular evaluation of central nervous system tumors.
Medicare pays $674.24 for 0481U 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
$674.24
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 0481U covers
0481U identifies a next-generation sequencing assay for CNS tumors that evaluates IDH1, IDH2, and the TERT promoter. The analysis detects single-nucleotide variants, insertions, and deletions across those targets. The three-target scope distinguishes this assay from single-gene testing and broader genomic panels. Results support molecular characterization of a CNS tumor and report sequence findings across the named targets.
Medicare pays 0481U through the Clinical Laboratory Fee Schedule (CLFS) at one national amount, which applies across localities without an office-versus-facility adjustment. The 2026 national CLFS amount is $674.24, unchanged from 2025. The code is paid only through the CLFS and has no physician fee schedule payment row.
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 0481U
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 0481U. 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 0481U: Medicare pays the test only from the CLFS.
0481U on the lab fee schedule since 2024
0481U · CLFS 2026 Q4 (current)
$674.24
Unchanged since Jan 1, 2025
Every change on file
- Jan 1, 2025 · CLFS 2025 Q1MAC-priced → $674.24
9 quarterly CLFS releases on file, first CLFS 2024 Q4. A code missing from a quarter wasn’t on that release.
0481U compared with similar tests
- 81120IDH1 testingCommon variants$193.25
- 81120 is limited to IDH1 analysis. 0481U evaluates IDH1, IDH2, and the TERT promoter in a CNS tumor assay.
- 81121IDH2 TestingCommon variants$295.79
- 81121 is limited to IDH2 analysis. 0481U evaluates IDH2 along with IDH1 and the TERT promoter.
- 81455Tumor genomic panel51+ genes, DNA or DNA/RNA$2,919.60
- 81455 covers large targeted genomic panels for neoplasms; 0481U focuses on IDH1, IDH2, and the TERT promoter in CNS tumors.
0481U billing questions
Which targets does 0481U cover?
It evaluates IDH1, IDH2, and the TERT promoter by next-generation sequencing in CNS tumors.
How does 0481U differ from 81120 or 81121?
81120 addresses IDH1 and 81121 addresses IDH2 individually. 0481U evaluates both genes and the TERT promoter in a CNS tumor assay.
What alteration types does the assay detect?
The assay detects single-nucleotide variants, insertions, and deletions.
How does Medicare pay for 0481U?
Medicare pays it through the CLFS at one national amount, with no locality or office-versus-facility adjustment.
Is a physician interpretation separately payable with 0481U?
0481U is paid only through the CLFS and has no physician fee schedule payment row.
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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