CPT code 81207: BCR::ABL1 test, minor breakpoint2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Qualitative or quantitative BCR::ABL1 testing for the minor breakpoint supports evaluation or monitoring of leukemias such as Philadelphia chromosome-positive acute lymphoblastic leukemia.
Medicare pays $144.84 for 81207 under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$144.84
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 8 sections
What 81207 covers
This molecular analysis detects or measures BCR::ABL1 involving the minor breakpoint, commonly associated with the p190 transcript. Hematologists and oncologists may order it when evaluating or monitoring leukemia, particularly Philadelphia chromosome-positive acute lymphoblastic leukemia. Testing is typically performed on peripheral blood or bone marrow by a molecular pathology laboratory, with results reported qualitatively or quantitatively.
Report this code when the laboratory evaluates the minor breakpoint; use 81206 for the major breakpoint and 81208 for another breakpoint category. Medicare pays the test through the CLFS at one national amount across localities, without an office-versus-facility difference. The 2026 national CLFS amount is $144.84, unchanged since 2020. The test is excluded from the physician fee schedule and paid only through the CLFS.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 81207
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 81207. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Excluded from the physician fee schedule
The physician fee schedule lists 81207 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81207 on the lab fee schedule since 2020
81207 · CLFS 2026 Q4 (current)
$144.84
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
81207 compared with similar tests
- 81206BCR-ABL1 testMajor breakpoint$163.96
- Choose 81206 for BCR::ABL1 involving the major breakpoint; 81207 is for the minor-breakpoint form.
- 81208BCR-ABL1 testOther breakpoint$214.62
- Choose 81208 when the laboratory analyzes another BCR::ABL1 breakpoint category; 81207 is specific to the minor breakpoint.
81207 billing questions
How does this code differ from 81206?
This code is for BCR::ABL1 involving the minor breakpoint, commonly associated with the p190 transcript. Code 81206 is for the major breakpoint.
When should 81208 be reported instead?
Use 81208 when the analysis targets another BCR::ABL1 breakpoint category rather than the minor breakpoint.
What specimens are typically tested?
Peripheral blood and bone marrow are typical specimens for BCR::ABL1 testing.
Can the analysis be qualitative or quantitative?
Yes. The minor-breakpoint analysis may be reported qualitatively or quantitatively.
Does Medicare pay a different rate by locality or setting?
No. The CLFS amount is national and applies across localities, with no office-versus-facility difference.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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