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Current CMS pricing and breakdown for Pain mgmt 11 endogenous anal.
National Medicare Payment
$840.65
This fee schedule does not publish separate facility and non-facility rates for this code.
Effective Q3 2026
This item has a standard price nationwide. Your local rate will likely match the amount shown above.
| Quarter | National Medicare Payment | YoY % Change |
|---|---|---|
| 2026 Q3 | $840.65 | +0.00% |
| 2026 Q2 | $840.65 | +0.00% |
| 2026 Q1 | $840.65 | +0.00% |
| 2025 Q4 | $840.65 | — |
| 2025 Q3 | $840.65 | — |
| 2025 Q2 | $840.65 | — |
| 2025 Q1 | $840.65 | — |
Pain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmalonate, 3hydroxypropyl mercapturic acid (3-hpma), quinolinic acid, kynurenic acid), lcms/ms, urine, algorithm reported as a pain-index score with likelihood of atypical biochemical function associated with pain
CPT code 0117U (Pain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmalonate, 3hydroxypropyl mercapturic acid (3-hpma), quinolinic acid, kynurenic acid), lcms/ms, urine, algorithm reported as a pain-index score with likelihood of atypical biochemical function associated with pain) had a 2026 Medicare non-facility reimbursement rate of $840.65. This reflects a 0.00% change from the prior year.
The 2026 National Medicare reimbursement for 0117U is $840.65. This item is paid at a standard national rate, so local variation is typically minimal.
Description: Pain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5hydroxyindoleacetic.... Payment policies and coverage rules can still vary by setting and claim details, so confirm final guidance through CMS when needed.
| Component | Office (Non-Fac) | Facility (Hosp) |
|---|---|---|
| Work RVU | ||
| Practice Expense (PE) | ||
| Malpractice (MP) | ||
| Total RVUs | 0.00 | 0.00 |
Compare a payment against the Medicare benchmark for this code.
Medicare rates are used as a benchmark only. Actual payer contracts, modifiers, place of service, units, and billing rules may affect reimbursement. This tool is for educational and operational review purposes, not legal or billing advice.
Facility vs. non-facility pricing most commonly applies to physician services paid under the RVU-based Physician Fee Schedule. For 0117U (Clinical Laboratory Test), the payment methodology may not include both facility and non-facility rates.
Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.
The 2026 National Average Medicare reimbursement rate for 0117U (Clinical Laboratory Test) is $840.65. This rate is effective as of January 1, 2026.
Pain management, analysis of 11 endogenous analytes (methylmalonic acid, xanthurenic acid, homocysteine, pyroglutamic acid, vanilmandelate, 5hydroxyindoleacetic acid, hydroxymethylglutarate, ethylmalonate, 3hydroxypropyl mercapturic acid (3-hpma), quinolinic acid, kynurenic acid), lcms/ms, urine, algorithm reported as a pain-index score with likelihood of atypical biochemical function associated with pain
Facility vs. non-facility differences usually apply to RVU-based physician services. 0117U may not use both facility and non-facility pricing depending on its payment methodology.
Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.
Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.