How Much Does Gene analysis of 55-74 genes associated with solid organ cancer in cell-free circulating dna, targeted genomic sequence analysis panel Cost on Medicare?

Cost analysis for CPT 0242U — Gene analysis of 55-74 genes associated with solid organ cancer in cell-free circulating dna, targeted genomic sequence analysis panel

Average Medicare Payment

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Total Payments (Latest)

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Services (Latest)

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Price Change (–)

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🗺️ State-by-State Cost Variation

The most expensive state pays 1.0x more than the cheapest for this procedure. CA averages $4890.35 vs CA at $4890.35.

State	Avg Payment	Total Payments	Services	Providers
CA	$4890.35	$104.7M	21.4K	1

💰 Who Bills the Most for This Procedure?

Provider	Specialty	State	Payments	Services	Avg/Service
Guardant Health, Inc.	Clinical Laboratory	CA	$104.7M	21.4K	$4890.35

🤔 Is Gene analysis of 55-74 genes associated with solid organ cancer in cell-free circulating dna, targeted genomic sequence analysis panel Overpriced?

Based on the data, CPT 0242U shows a 1.0x variation in pricing across states — relatively consistent by Medicare standards.

Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.

Data Sources

• Centers for Medicare & Medicaid Services (CMS)
• Medicare Provider Utilization and Payment Data (2014-2023)
• Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.