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2021 Clinical Diagnostic Laboratory Fee Schedule CPT Codes, Descriptions and Other Data Only Are Copyright 2021 American Medical Association 2021 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA). YEAR HCPCS MOD EFF_DATE INDICATOR RATE2021 SHORTDESC LONGDESC 2021 0001U 20210101 N 00720.00 Rbc dna hea 35 ag 11 bld grp Red blood cell typing 2021 0002M 20210101 N 00503.40 Liver dis 10 assays w/ash Liver disease, ten biochemical assays (alt, a2-macroglobulin, apolipoprotein 2021 0002U 20210101 N 00025.00 Onc clrct 3 ur metab alg plp Measurement of substances in urine to predict likelihood of polyps in large 2021 0003M 20210101 N 00503.40 Liver dis 10 assays w/nash Liver disease, ten biochemical assays (alt, a2-macroglobulin, apolipoprotein 2021 0003U 20210101 N 00950.00 Onc ovar 5 prtn ser alg scor Measurement of proteins associated with ovarian cancer in serum 2021 0004M 20210101 N 00079.00 Scoliosis dna alys Scoliosis, dna analysis of 53 single nucleotide polymorphisms (snps), using 2021 0005U 20210101 N 00760.00 Onco prst8 3 gene ur alg Test for detecting genes associated with prostate cancer in urine 2021 0006M 20210101 N 00150.00 Onc hep gene risk classifier Oncology (hepatic), mrna expression levels of 161 genes, utilizing fresh 2021 0007M 20210101 N 00375.00 Onc gastro 51 gene nomogram Oncology (gastrointestinal neuroendocrine tumors), real-time pcr expression 2021 0007U 20210101 N 00114.43 Rx test prsmv ur w/def conf Testing for presence of drug in urine 2021 0008U 20210101 N 00597.91 Hpylori detcj abx rstnc dna Test for detecting Helicobacter pylori genes associated with antibiotic 2021 0009U 20210101 N 00107.00 Onc brst ca erbb2 amp/nonamp Gene analysis of breast tumor tissue 2021 0010U 20210101 N 00427.26 Nfct ds strn typ whl gen seq Typing of bacterial strain 2021 0011M 20210101 N 00760.00 Onc prst8 ca mrna 12 gen alg Oncology, prostate cancer, mrna expression assay of 12 genes (10 content and 2 2021 0011U 20210101 N 00114.43 Rx mntr lc-ms/ms oral fluid Prescription drug monitoring in oral fluid 2021 0012M 20210101 N 00760.00 Onc mrna 5 gen rsk urthl ca Oncology (urothelial), mrna, gene expression profiling by real-time 2021 0012U 20210101 N 02515.60 Germln do gene reargmt detcj Gene analysis for germline disorder 2021 0013M 20210101 N 00760.00 Onc mrna 5 gen recr urthl ca Oncology (urothelial), mrna, gene expression profiling by real-time 2021 0013U 20210101 N 02515.60 Onc sld org neo gene reargmt Gene analysis of solid organ tumor tissue 2021 0014M 20210101 N 00176.19 Liver ds alys 3 bmrk srm alg Liver disease, analysis of 3 biomarkers (hyaluronic acid [ha], procollagen iii 2021 0014U 20210101 N 02515.60 Hem hmtlmf neo gene reargmt DNA test for detecting gene abnormality associated with blood and lymphatic 2021 0015M 20210101 L 00000.00 Adrnl cortcl tum bchm asy 25 Adrenal cortical tumor, biochemical assay of 25 steroid markers, utilizing 2021 0016M 20210101 L 00000.00 Onc bladder mrna 209 gen alg Oncology (bladder), mrna, microarray gene expression profiling of 209 genes, 2021 0016U 20210101 N 00163.96 Onc hmtlmf neo rna bcr/abl1 RNA test for detecting gene abnormality associated with blood and lymphatic 2021 0017U 20210101 N 00091.66 Onc hmtlmf neo jak2 mut dna JAK2 mutation test for detecting gene abnormality associated with blood and 2021 0018U 20210101 N 03002.09 Onc thyr 10 microrna seq alg MicroRNA gene analysis of thyroid nodule tissue 2021 0019U 20210101 N 03675.00 Onc rna tiss predict alg RNA gene analysis of tumor tissue 2021 0021U 20210101 N 00760.00 Onc prst8 detcj 8 autoantb Detection of 8 autoantibodies in prostate tissue 2021 0022U 20210101 N 01950.00 Trgt gen seq dna&rna 23 gene DNA and RNA gene analysis for non-small cell lung cancer 2021 0023U 20210101 N 00248.51 Onc aml dna detcj/nondetcj DNA gene analysis for acute myelogenous leukemia 2021 0024U 20210101 N 00034.19 Glyca nuc mr spectrsc quan Measurement of glycosylated acute phase proteins 2021 0025U 20210101 N 00085.77 Tenofovir liq chrom ur quan Measurement of tenovir in urine 2021 0026U 20210101 N 03600.00 Onc thyr dna&mrna 112 genes DNA and microRNA gene analysis of thyroid nodule tissue 2021 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA). YEAR HCPCS MOD EFF_DATE INDICATOR RATE2021 SHORTDESC LONGDESC 2021 0027U 20210101 N 00121.91 Jak2 gene trgt seq alys Gene analysis (Janus kinase 2) of targeted sequence exons 12-15 2021 0029U 20210101 N 00742.27 Rx metab advrs trgt seq alys Gene analysis of targeted sequences for adverse drug reactions and drug response 2021 0030U 20210101 N 00134.13 Rx metab warf trgt seq alys Gene analysis of targeted sequences for warfarin drug response 2021 0031U 20210101 N 00174.81 Cyp1a2 gene Gene analysis (cytochrome P450 family 1, subfamily A, member 2) for common 2021 0032U 20210101 N 00174.81 Comt gene Gene analysis (catechol-O-methyltransferase) for c.472G>A (rs4680) variant 2021 0033U 20210101 N 00349.62 Htr2a htr2c genes Gene analysis (5-hydroxytryptamine receptor 2A) for common variants 2021 0034U 20210101 N 00466.17 Tpmt nudt15 genes Gene analysis (thiopurine S-methyltransferase) for common variants 2021 0035U 20210101 N 00540.99 Neuro csf prion prtn qual Testing for presence of prion protein in cerebrospinal fluid 2021 0036U 20210101 N 04780.00 Xome tum & nml spec seq alys Exome gene analysis for somatic mutation in tumor tissue 2021 0037U 20210101 N 03500.00 Trgt gen seq dna 324 genes DNA gene analysis of 324 genes in solid organ tumor tissue 2021 0038U 20210101 N 00029.60 Vitamin d srm microsamp quan Measurement of vitamin D in serum 2021 0039U 20210101 N 00013.74 Dna antb 2strand hi avidity Testing for anti-DNA antibody 2021 0040U 20210101 N 00409.90 Bcr/abl1 gene major bp quan Gene analysis (t(9;22)) for translocation analysis 2021 0041U 20210101 N 00017.21 B brgdrferi antb 5 prtn igm IgM antibody detection test for Borrelia burgdorferi 2021 0042U 20210101 N 00017.21 B brgdrferi antb 12 prtn igg IgG antibody detection test for Borrelia burgdorferi 2021 0043U 20210101 N 00014.86 Tbrf b grp antb 4 prtn igm IgM antibody detection test for Tick-Borne Relapsing Fever Borrelia group (IgM) 2021 0044U 20210101 N 00014.86 Tbrf b grp antb 4 prtn igg IgM antibody detection test for Tick-Borne Relapsing Fever Borrelia group (IgG) 2021 0045U 20210101 N 03873.00 Onc brst dux carc is 12 gene mRNA gene analysis of 12 genes in breast ductal carcinoma in situ tumor tissue 2021 0046U 20210101 N 00407.43 Flt3 gene itd variants quan Gene analysis (fms-related tyrosine kinase 3) for internal tandem duplication 2021 0047U 20210101 N 03873.00 Onc prst8 mrna 17 gene alg mRNA gene analysis of 17 genes in prostate tumor tissue 2021 0048U 20210101 N 02919.60 Onc sld org neo dna 468 gene DNA gene analysis of 468 genes in solid organ tumor tissue 2021 0049U 20210101 N 00407.43 Npm1 gene analysis quan Gene analysis (nucleophosmin) 2021 0050U 20210101 N 02916.60 Trgt gen seq dna 194 genes DNA gene analysis of targeted sequences in 194 genes for acute myelogenous 2021 0051U 20210101 N 00193.71 Rx mntr lc-ms/ms ur 31 pnl Testing for presence of 31 prescription drugs in urine 2021 0052U 20210101 N 00033.86 Lpoprtn bld w/5 maj classes Measurement of all five major lipoprotein classes and subclasses in blood 2021 0053U 20210101 N 02030.00 Onc prst8 ca fish alys 4 gen FISH analysis of 4 genes in prostate needle biopsy specimen 2021 0054U 20210101 N 00148.96 Rx mntr 14+ drugs & sbsts Measurement of 14 or more drug classes in capillary blood 2021 0055U 20210101 N 03240.00 Card hrt trnspl 96 dna seq DNA gene analysis of 96 target sequences in plasma for heart transplant 2021 0056U 20210101 N 02515.60 Hem aml dna gene reargmt Whole genome sequencing in blood or bone marrow for acute myelogenous leukemia 2021 0058U 20210101 N 00322.96 Onc merkel cll carc srm quan Measurement of antibodies to Merkel cell polyoma virus oncoprotein in serum 2021 0059U 20210101 N 00322.96 Onc merkel cll carc srm +/- Test for presence of antibodies to Merkel cell polyoma virus oncoprotein in 2021 0060U 20210101 N 00759.05 Twn zyg gen seq alys chrms2 Gene analysis for identical twins in maternal blood 2021 0061U 20210101 N 00025.10 Tc meas 5 bmrk sfdi m-s alys Spatial frequency domain imaging of skin 2021 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2021 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA). YEAR HCPCS MOD EFF_DATE INDICATOR RATE2021 SHORTDESC LONGDESC 2021 0062U 20210101 N 00380.72 Ai sle igg&igm alys 80 bmrk IgG and IgM analysis of 80 biomarkers of systemic lupus erythematosus in serum 2021 0063U 20210101 N 00750.00 Neuro autism 32 amines alg Testing for amines associated with autism spectrum disorder in plasma 2021 0064U 20210101 N 00031.33 Antb tp total&rpr ia qual Antibody testing for syphilis 2021 0065U 20210101 N 00018.09 Syfls tst nontreponemal antb Non-antibody testing for syphilis 2021 0066U 20210101 N 00015.29 Pamg-1 ia cervico-vag fluid Measurement of placental alpha-micro globulin-1 (PAMG-1) in cervical/vaginal 2021 0067U 20210101 N 01897.00 Onc brst imhchem prfl 4 bmrk Protein expression profiling of 4 biomarkers of breast cancer in precancerous 2021 0068U 20210101 N 00142.63 Candida species pnl amp prb Detection of Candida species by amplified probe 2021 0069U 20210101 N 00380.00 Onc clrct
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