HCPCS code G0476: HPV screening, high-risk types with Pap2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This nucleic acid assay detects high-risk human papillomavirus types for cervical cancer screening when performed in addition to a Pap test.
Medicare pays $35.09 for G0476 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
$35.09
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- 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 G0476 covers
G0476 represents nucleic acid testing for high-risk human papillomavirus in cervical cancer screening. The assay detects HPV genetic material as DNA or RNA and is performed in addition to Pap cytology. It reports the HPV screening service rather than the cytology examination.
Report G0476 for the HPV assay in addition to the applicable Pap cytology service when both are performed. Medicare pays the test only through the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $35.09 and has remained unchanged since 2020. The same amount applies in every state and locality, with no geographic or office-versus-facility adjustment. The test is excluded from the physician fee schedule by statute.
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 G0476
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 G0476. 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.
Excluded from the physician fee schedule
The physician fee schedule lists G0476 with status X (excluded by statute), so the test itself is paid only from the CLFS.
G0476 on the lab fee schedule since 2020
G0476 · CLFS 2026 Q4 (current)
$35.09
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
G0476 compared with similar tests
- G0145Cervical cytologyAutomated screen, manual rescreen$26.49
- G0145 reports Pap cytology; G0476 reports the additional high-risk HPV nucleic acid screening assay. Both may be reported when both services are performed.
- 87624High-risk HPVPooled result$35.09
- 87624 is another code for high-risk HPV nucleic acid testing. G0476 is specific to cervical cancer screening performed in addition to a Pap test.
- 87625HPV genotypingTypes 16 and 18$40.55
- 87625 is for nucleic acid testing focused on HPV types 16 and 18. G0476 represents high-risk HPV screening performed in addition to a Pap test.
G0476 billing questions
How does G0476 differ from CPT 87624?
G0476 is for high-risk HPV nucleic acid testing for cervical cancer screening performed in addition to a Pap test. CPT 87624 is another code for high-risk HPV nucleic acid testing.
Is G0476 reported with a Pap cytology service?
Yes. G0476 describes the HPV screening assay performed in addition to a Pap test; report the applicable Pap service when both are performed.
Does G0476 identify a specific HPV genotype?
No. It represents high-risk HPV screening rather than a test focused on a specific genotype, such as HPV 16 and 18.
Does Medicare pay G0476 under the physician fee schedule?
No. Medicare pays the test through the CLFS; it is excluded from the physician fee schedule by statute.
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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