CPT code 81219: CALR testing, common exon 9 variants2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Molecular analysis of common CALR variants supports evaluation of suspected myeloproliferative neoplasms, including essential thrombocythemia and primary myelofibrosis.
Medicare pays $121.63 for 81219 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
$121.63
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 81219 covers
This molecular test looks for common variants in exon 9 of the CALR gene. It is commonly used when evaluating a suspected myeloproliferative neoplasm, particularly essential thrombocythemia or primary myelofibrosis. Testing may be performed by a molecular laboratory on peripheral blood or bone marrow material. CALR findings are interpreted alongside the patient’s blood counts, clinical picture, and other molecular results; the test is not a general full-gene sequencing service.
Report one service for the CALR common-variant analysis performed; the code does not represent a separate charge for each variant found. Medicare pays this test through the Clinical Laboratory Fee Schedule only. The 2026 national CLFS amount is $121.63, the same amount listed for every year from 2020 through 2026. That amount applies nationally, without a locality or office-versus-facility adjustment. The physician fee schedule assigns no separate payment to this test.
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 81219
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 81219. 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 81219 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81219 on the lab fee schedule since 2020
81219 · CLFS 2026 Q4 (current)
$121.63
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.
81219 compared with similar tests
- 81270JAK2 testV617F variant$91.66
- 81270 analyzes common JAK2 variants; 81219 analyzes common CALR variants. The gene tested, not the general purpose of the workup, determines the code.
- 81338MPL testingCommon variants$150.33
- 81338 is for common MPL variants, while 81219 is for common CALR variants. These are distinct molecular analyses used in evaluation of myeloproliferative neoplasms.
- 81206BCR-ABL1 testMajor breakpoint$163.96
- 81206 tests for the BCR::ABL1 major-breakpoint target; it is not a CALR variant assay. Select according to the molecular target actually analyzed.
81219 billing questions
When is 81219 selected instead of JAK2 testing?
Use 81219 for analysis of common CALR variants, not for JAK2 analysis. CALR and JAK2 testing may both be part of a molecular evaluation for a suspected myeloproliferative neoplasm.
Does 81219 cover full CALR gene sequencing?
No. It represents testing for common CALR variants in exon 9, rather than full-gene sequencing.
Are units reported for each CALR variant detected?
No. The service is the common-variant analysis, not a separate unit for every variant detected.
Can CALR testing be performed on blood or bone marrow?
Yes. Peripheral blood and bone marrow material are commonly used for this molecular evaluation.
How does Medicare pay for 81219?
Medicare pays the test through the CLFS at one national amount, with no geographic or office-versus-facility adjustment. The physician fee schedule provides no separate payment for this code.
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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