CPT 0264U Pathology/Laboratory

Detection of abnormalities associated with rare heritable diseases by optical Cost

Body System: General

Medicare Facility Rate
$1,264
CMS PFS CY2026
Medicare Non-Facility Rate
$1,264
Office/clinic setting

Frequently Asked Questions

How much does Detection of abnormalities associated with rare heritable diseases by optical cost?

The Medicare facility rate is $1,264. Commercial insurance typically pays 150-250% of Medicare rates (varies).

How much does Detection of abnormalities associated with rare heritable diseases by optical cost without insurance?

Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $1,264.

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