CPT/HCPCS Section
Proprietary Laboratory Analyses (PLA)
108 procedure codes with Medicare Physician Fee Schedule payment data. Click a code for Facility vs Non-Facility rates, allowed amounts and utilization.
0001URed blood cell typing$526→0005UTest for detecting genes associated with prostate cancer in urine$744→0018UMicrorna gene analysis of thyroid nodule tissue$2920→0023UDna gene analysis for acute myelogenous leukemia$244→0024UMeasurement of glycosylated acute phase proteins$30→0026UDna and microrna gene analysis of thyroid nodule tissue$3520→0027UGene analysis (janus kinase 2) of targeted sequence exons 12-15$118→0029UGene analysis of targeted sequences for adverse drug reactions and drug response$672→0034UGene analysis (thiopurine s-methyltransferase) for common variants$440→0035UTesting for presence of prion protein in cerebrospinal fluid$495→0037UDna gene analysis of 324 genes in solid organ tumor tissue$3418→0041UIgm antibody detection test for borrelia burgdorferi$17→0042UIgg antibody detection test for borrelia burgdorferi$17→0043UIgm antibody detection test for tick-borne relapsing fever borrelia group (igm)$15→0044UIgm antibody detection test for tick-borne relapsing fever borrelia group (igg)$15→0045UMrna gene analysis of 12 genes in breast ductal carcinoma in situ tumor tissue$3796→0047UMrna gene analysis of 17 genes in prostate tumor tissue$3783→0058UMeasurement of antibodies to merkel cell polyoma virus oncoprotein in serum$317→0059UTest for presence of antibodies to merkel cell polyoma virus oncoprotein in serum$317→0061USpatial frequency domain imaging of skin$25→0064UAntibody testing for syphilis$30→0065UNon-antibody testing for syphilis$14→0068UDetection of candida species by amplified probe$131→0077UDetection of immunoglobulin paraprotein (m-protein) in blood or urine$42→0080UAnalysis of galectin-3-binding protein and scavenger receptor cysteine-rich type 1 protein m130 in plasma, with clinical risk factors, to evaluate probability of lung cancer$3447→0089UGene expression profiling of melanoma in superficial sample collected by adhesive patch$744→0090UMrna gene expression profiling of 23 genes in skin melanoma tissue sample$1911→0101UGene sequence analysis panel of 15 genes associated with hereditary colon cancer and related disorders$1709→0105UMeasurement of tumor necrosis factor receptor 1a, receptor superfamily 2 (tnfr1, tnfr2), and kidney injury molecule-1 (kim-1) in plasma to evaluate risk of rapid kidney function decline$931→0106UEvaluation of gastric emptying by measurement of radiolabeled carbon dioxide in breath specimens$857→0108UComputer-assisted digital imaging of esophagus specimen slides to evaluate risk of cancer$4851→0112UGene analysis for detection of infectious agent and drug resistance gene$348→0118UMeasurement of transplant donor cell-free dna in transplant recipient plasma$2677→0119UMeasurement of ceramides for assessment of heart disease risk$82→0129UGene analysis of genes associated with hereditary breast cancer and related disorders for gene sequence and duplication or deletion variants$1279→0152UCell-free dna sequencing of disease-causing organisms in plasma specimen, with report for significant organisms$2079→0164UTest for detection of antibodies associated with irritable bowel syndrome in plasma specimen, reported as elevated or not elevated$110→0166ULiver disease test panel in serum specimen$493→0172UDna gene analysis (brca1, dna repair associated and brca2, dna repair associated) for detection of mutations associated with breast cancer$2961→0174UMass spectrometry testing for 30 protein targets in tissue specimen to predict benefit of cancer therapy agents$1279→0202UTest for detection of respiratory disease-causing organisms from back of nose and throat (nasopharynx) specimen, 22 target organisms including severe acute respiratory syndrome coronavirus 2$408→0206UCell aggregation testing of cultured skin cells for alzheimer disease, reported as positive or negative for alzheimer disease$2164→0207UImmunofluorescence testing of cultured skin cells for alzheimer disease, reported as probability index for alzheimer disease$495→0239UGene analysis of 311 or more genes associated with solid organ cancer in cell-free dna, targeted sequence panel$3423→0240URespiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid-19), influenza a, and influenza b) in upper respiratory specimen, each reported as detected or not detected$140→0241URespiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected$139→0242UGene analysis of 55-74 genes associated with solid organ cancer in cell-free circulating dna, targeted genomic sequence analysis panel$4893→0245UGene analysis of 10 genes and 37 rna fusions and expression of 4 mrna markers, next-generation sequencing, in fine needle aspirate of thyroid to evaluate risk of thyroid cancer$1236→0250UGene analysis of 505 genes associated with solid organ cancer in tumor tissue sample, targeted genomic sequence interrogation for somatic alterations, microsatellite instability and tumor-mutation burden$2861→0288UPcr measurement of 11 genes (bag1, brca1, cdc6, cdk2ap1, erbb3, fut3, il11, lck, rnd3, sh3bgr, wnt3a) and 3 reference genes (esd, tbp, yap1), in tumor tissue, with algorithmic interpretation reported as a recurrence risk score$3794→0295UProtein expression profiling by immunohistochemistry of 7 proteins (cox2, foxa1, her2, ki-67, p16, pr, siah2), with 4 clinicopathologic factors (size, age, margin status, palpability), in breast ductal carcinoma in situ tumor tissue, algorithm reported as$5321→0308UAnalysis of 3 proteins in plasma specimen, algorithm reported as risk score for obstructive coronary heart disease$383→0309UAnalysis of 4 proteins (nt-probnp, osteopontin, tissue inhibitor of metalloproteinase-1 [timp-1], and kidney injury molecule-1 [kim-1]) in plasma specimen, algorithm reported as risk score for major adverse heart event$383→0311UMeasurement of bacterial susceptibility to antibiotics, reported as phenotypic minimum inhibitory concentration (mic) for each organism identified$8→0312UAnalysis of 8 igg autoantibodies and 2 cell-bound complement activation products associated with autoimmune disease, using enzyme-linked immunosorbent immunoassay (elisa), flow cytometry and indirect immunofluorescence in serum specimen or plasma and whole$824→0315UMrna gene expression profiling by real-time polymerase chain reaction (rt-pcr) of 40 genes (34 content and 6 housekeeping) associated with squamous cell carcinoma of skin in formalin-fixed paraffin-embedded (ffpe) tissue specimen, algorithm reported as ben$8330→0320URna gene expression profiling by select transcriptome sequencing in peripheral blood specimen taken after kidney transplant, algorithm reported as risk score for acute cellular rejection$2597→0326UTargeted genomic sequence analysis of 83 or more genes in cell free circulating dna for detection of abnormalities associated with solid organ cancers$4892→0329UExome and transcriptome sequence analysis of dna and rna from tumor with dna from normal blood or saliva for subtraction, report of clinically significant mutations with therapy associations$3369→0334UTargeted genomic sequence analysis of 84 or more genes for detection of abnormalities associated with cancer of body organ$3075→0337UEvaluation of plasma cells for detection of abnormalities associated with plasma cell disorders and myeloma$2386→0338UEvaluation of circulating solid tumor cells in peripheral blood$2386→0339UMrna expression profiling of genes associated with high-grade prostate cancer$743→0340UDna assays for detection of minimal residual disease in cancer$3519→0344UEvaluation of 28 lipid markers for risk of nonalcoholic fatty liver disease$775→0345UGenomic analysis panel of 15 genes for detection of abnormalities assocated with mental health disorders$1308→0346UEvaluation of beta amyloid ab40 and ab42 ratio$91→0347UDna analysis of 16 genes involved in drug metabolism or processing$1309→0348UDna analysis of 25 genes involved in drug metabolism or processing$727→0349UDna analysis of 27 genes involved in drug metabolism or processing, report including gene-drug interactions$671→0351UBiochemical assays for markers of bacterial infection$248→0352UDetection of bacteria causing vaginosis and vaginitis by multiplex amplified nucleic acid probe technique$136→0353UDetection of chlamydia trachomatis and neisseria gonorrhoeae by multiplex amplified dna probe technique$67→0355UEvaluation of apolipoprotein l1 risk variants$134→0356UEvaluation of 17 dna biomarkers reported as a risk score for cancer recurrence$1545→0358UEnzyme immunoassay analysis of beta-amyloid fragments in cerebral spinal fluid to evaluate mild mental impairment$255→0359UPhase separation and immunoassay evaluation of prostate-specific antigen (psa) in plasma to evaluate risk of prostate cancer$724→0360UEnzyme-linked immunosorbent assay of autoantibodies in plasma to evaluate risk of malignancy in lung cancer$823→0361UDigital immunoassay in plasma for neurofilament light chain$17→0363UGene-expression profiling of 5 genes in urine reported as a risk score for having urothelial carcinoma$741→0365UTest for 10 protein biomarkers for bladder cancer$879→0366UTest for 10 protein biomarkers for recurrent bladder cancer$879→0375UTest for proteins to determine risk for ovarian cancer$877→0376UTest to determine potential risk of prostate cancer spread and mortality$692→0379UGenomic testing for solid organ cancer$3341→0380UTest for adverse drug reactions and drug response$408→0388UNext-generation sequencing in plasma of 37 cancer-related genes, with report for alteration detection in non-small cell lung cancer$3414→0393UDetection of protein by seed amplification assay for neurological disorders$530→0394UTesting of plasma or serum for 16 perfluoroalkyl substances (pfas) compounds$195→0398UDna methylation analysis using polymerase chain reaction testing of tissue for genes specific to barrett esophagus, reported as a risk score for progression to high grade dysplasia or cancer$1899→0403UMrna expression profiling of 18 genes to detect potential risk of prostate cancer$742→0404UAnalysis of serum using immunoassay technique for thymidine kinase activity in breast cancer$317→0406UFlow cytometry detection of 5 markers in sputum to evaluate potential for lung cancer$745→0407UMeasurement of soluble tumor necrosis factor receptor 1 (stnfr1), soluble tumor necrosis receptor 2 (stnfr2), and kidney injury molecule 1 (kim-1) to evaluate risk of progressive decline in kidney function in diabetic chronic kidney disease$924→0409UNext-generation sequencing of dna (80 genes) and rna (39 genes) in plasma showing mutations and clinical actionability in solid tumor cancers$2861→0411UGenomic analysis of 15 genes to evaluate for psychiatric disorders$1292→0415UTest of biomarkers in blood combined with patient factors to determine a 5-year risk score for acute coronary syndrome$383→0422UOnc pan solid tum alys dna$1897→0430UGi malabs aat calpro pncrtc$149→0431UGly rcptr alpha1 igg srm/csf$24→0432UKlhl11 antb sr/csf asy qual$21→0433UOnc prst8 5 dna reg mrk pcr$745→0434URx metab advrs vrnt alys 25$586→0443UNeurflmnt lt chn ultrsens ia$56→0456UAi ra ngs 19 genes anti-ccp$1720→0473UOnc sld tum bld/slv 648 gene$4410→0475UHered prst8 ca gsap 23 genes$1698→0485UOnc sol tum cfdna&rna ngs gm$3576→