CPT code 0583U: Comparator sequencing, rapid whole genome2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Rapid whole genome comparator sequencing analyzes rare-disease variants and reports them alongside proband results as an add-on to the primary procedure.
Medicare pays $3,791.10 for 0583U 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
$3,791.10
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 8 sections
What 0583U covers
0583U covers rapid whole genome sequencing of a comparator’s blood, saliva, or tissue sample for rare diseases, including constitutional or hereditary disorders. The analysis evaluates single-nucleotide variants, insertions and deletions, and copy number variations. Results are reported with the proband’s results, so this service contributes comparator findings to a rare-disease genome analysis rather than serving as the proband’s primary test.
Report 0583U separately in addition to the primary procedure. Medicare pays it under the Clinical Laboratory Fee Schedule (CLFS) at one national amount per code across states and localities, with no geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $3,791.10. The code is paid only through the CLFS; it has no physician fee schedule payment.
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 0583U
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 0583U. 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 0583U: Medicare pays the test only from the CLFS.
0583U on the lab fee schedule since 2025
0583U · CLFS 2026 Q4 (current)
$3,791.10
Unchanged since Jan 1, 2026
Every change on file
- Jan 1, 2026 · CLFS 2026 Q1MAC-priced → $3,791.10
5 quarterly CLFS releases on file, first CLFS 2025 Q4. A code missing from a quarter wasn’t on that release.
0583U compared with similar tests
- 0582URapid genome testVariant reporting$7,582.20
- 0582U is the primary rapid rare-disease genome analysis; 0583U adds comparator sequencing, with findings reported alongside the proband’s results.
- 81426Genome sequencingEach comparator genome$2,709.95
- 81426 is a comparator genome analysis code in a different coding context. 0583U is the comparator add-on for the rapid rare-disease sequencing pathway.
- 81425Genome sequencingConstitutional or heritable disorders$5,031.20
- 81425 represents proband genome analysis, not comparator sequencing. 0583U reports comparator findings with the primary rapid rare-disease genome analysis.
0583U billing questions
When is 0583U reported with 0582U?
Report 0583U for comparator sequencing alongside the primary rapid whole genome analysis represented by 0582U.
Does 0583U replace the primary genome analysis?
No. It is reported separately as an add-on to the primary procedure, with comparator variants reported alongside the proband’s results.
Which specimens and variants are included?
The comparator sample may be blood, saliva, or tissue. The analysis covers single-nucleotide variants, insertions and deletions, and copy number variations.
How does Medicare pay 0583U?
Medicare pays 0583U under the CLFS at one national amount across localities, without geographic or 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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