CPT 0242U: what Medicare pays in 2026
Proprietary lab test
0242U is on Medicare's Clinical Laboratory Fee Schedule at $5,000.00 for 2026, one national amount that does not vary by locality.
CPT descriptions are copyrighted by the American Medical Association, so this page shows the code number only. The description printed on your bill, or the provider, will tell you what the code covers.
Medicare amounts for 0242U in 2026
- Hospital outpatient status A
- paid from a different Medicare fee schedule, not the outpatient system
- Clinical Laboratory Fee Schedule, national
- $5,000.00
What providers charged Medicare for 0242U in 2024
From CMS's national utilization file (the most recent full year published). The charge is the provider's list price, the same kind of figure an uninsured patient is usually billed.
| Setting | Services | Average charge | Medicare allowed | Charge vs allowed |
|---|---|---|---|---|
| In an office or other non-facility setting | 20,206 | $8,550.00 | $4,892.70 | 1.7× |