CPT code 0579U: Kidney risk test, plasma ELISA risk score2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A plasma ELISA measures two proteins and combines their results with eGFR and age to report a kidney function decline risk score in diabetic CKD.
Medicare pays $390.75 for 0579U 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
$390.75
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2026
- 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 0579U covers
0579U identifies a proprietary laboratory analysis for diabetic chronic kidney disease. The laboratory tests plasma for apolipoprotein A4 and CD5 antigen-like protein using ELISA. An algorithm combines the protein findings with estimated glomerular filtration rate and age, then reports a risk score for kidney function decline. The result addresses decline risk in diabetic CKD rather than reporting either protein measurement or eGFR alone.
Report 0579U for the combined analysis and risk score; the protein measurements, eGFR, age, and calculated score are parts of that service, not separate 0579U services. Medicare pays it under the CLFS at one national amount across states and localities, without an office-versus-facility difference. The 2026 national CLFS amount is $390.75.
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 0579U
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 0579U. 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 0579U: Medicare pays the test only from the CLFS.
0579U on the lab fee schedule since 2025
0579U · CLFS 2026 Q4 (current)
$390.75
Unchanged since Jan 1, 2026
Every change on file
- Jan 1, 2026 · CLFS 2026 Q1MAC-priced → $390.75
5 quarterly CLFS releases on file, first CLFS 2025 Q4. A code missing from a quarter wasn’t on that release.
0579U compared with similar tests
- 82565CreatinineBlood specimen$5.12
- 82565 measures creatinine, used in routine kidney assessment. 0579U combines plasma protein findings with eGFR and age to report a kidney-decline risk score.
- 82043Urine albuminQuantitative measurement$5.78
- 82043 measures urine albumin. 0579U tests plasma proteins and combines the findings with eGFR and age to report a kidney function decline risk score.
- 80069Renal panelKidney-focused chemistry panel$8.68
- 80069 is a renal function panel of routine chemistry tests. 0579U is a protein-based analysis that reports a risk score for kidney function decline in diabetic CKD.
0579U billing questions
What specimen and method does 0579U describe?
The assay uses plasma and measures apolipoprotein A4 and CD5 antigen-like protein by ELISA. The results are combined with eGFR and age in an algorithm.
How is 0579U different from a routine creatinine test?
A creatinine test measures creatinine, which is used in routine kidney assessment. 0579U tests two plasma proteins and combines the results with eGFR and age to report a kidney-decline risk score.
Are the protein measurements and risk-score calculation separate 0579U services?
No. 0579U describes the combined analysis and algorithmic risk score; the protein measurements, eGFR, and age are parts of that service.
How does Medicare pay for 0579U?
Medicare pays the code under the CLFS using one national amount across localities, without an 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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