CPT code 81228: Chromosomal microarray, CGH copy-number analysis2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Genome-wide CGH microarray analysis identifies chromosomal copy-number gains and losses, often in patients evaluated for developmental delay, intellectual disability, or congenital anomalies.
Medicare pays $900.00 for 81228 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
$900.00
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 81228 covers
This laboratory analysis uses comparative genomic hybridization (CGH) microarray methods to assess chromosome-wide DNA copy-number changes. It is commonly ordered as part of a constitutional genetic evaluation for developmental delay, intellectual disability, autism, or multiple congenital anomalies. Peripheral blood is a common specimen. The assay evaluates DNA dosage changes rather than sequence-level variants or balanced chromosome rearrangements.
Report 81228 for the genome-wide CGH microarray analysis, not by the number of chromosomes or copy-number findings. Medicare pays it through the CLFS at one nationally set amount, with no locality or office-versus-facility adjustment. The 2026 national CLFS amount is $900.00, unchanged since 2020. The test is 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 81228
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 81228. 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 81228 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81228 on the lab fee schedule since 2020
81228 · CLFS 2026 Q4 (current)
$900.00
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.
81228 compared with similar tests
- 81229Chromosomal microarrayCopy number and SNP analysis$1,160.00
- 81228 is CGH microarray copy-number analysis. Choose 81229 when the genome-wide assay also includes SNP genotyping.
- 88262Chromosome analysis15–20 cells, two karyotypes$125.49
- 88262 reports constitutional chromosome analysis by karyotype; 81228 reports genome-wide CGH microarray analysis of DNA copy-number changes.
- 88271DNA probeEach probe$21.42
- 88271 is molecular cytogenetic analysis using targeted DNA probes. Code 81228 is a genome-wide microarray approach.
81228 billing questions
How does 81228 differ from 81229?
81228 describes genome-wide CGH microarray analysis for copy-number variants. Code 81229 describes a related microarray approach that also includes SNP genotyping.
When is this analysis typically ordered?
It is commonly used in constitutional evaluations of developmental delay, intellectual disability, autism, or multiple congenital anomalies when a genome-wide assessment of DNA copy-number changes is sought.
Is the code reported per chromosome or finding?
No. It represents the genome-wide CGH microarray analysis, not a separate unit for each chromosome or copy-number finding.
What should the record support?
Document the constitutional clinical indication, the order for genome-wide CGH microarray analysis, and the laboratory service performed.
How does Medicare price this code?
Medicare pays one national CLFS amount for the code across localities, without an 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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