CPT code 81275: KRAS testing, exon 2 variants2026 Medicare lab fee · Clinical Laboratory Fee Schedule
KRAS exon 2 gene analysis identifies variants, including codons 12 and 13, in colorectal carcinoma biomarker evaluation.
Medicare pays $193.25 for 81275 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
$193.25
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 81275 covers
81275 represents laboratory analysis of KRAS (Kirsten rat sarcoma viral oncogene) variants in exon 2, including codons 12 and 13. It is commonly ordered in colorectal carcinoma biomarker evaluation when these variants are the target. A molecular pathology laboratory performs and reports the gene analysis. The code distinguishes exon 2 testing from additional KRAS variant analysis and from a broader multigene tumor panel.
Report 81275 for the exon 2 analysis; when additional KRAS variants are also analyzed, report 81276 as an add-on. Medicare pays 81275 through the CLFS at one national amount per code that applies in all localities, without an office-versus-facility adjustment. The 2026 national CLFS amount is $193.25 and has been unchanged since 2020. Physician fee schedule status X classifies the test as paid through the CLFS only.
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 81275
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 81275. 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 81275 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81275 on the lab fee schedule since 2020
81275 · CLFS 2026 Q4 (current)
$193.25
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.
81275 compared with similar tests
- 81276KRAS testingBeyond exon 2$193.25
- 81275 covers KRAS exon 2 variants, including codons 12 and 13. Report 81276 as an add-on for additional KRAS variants.
- 81445Tumor gene panel5–50 genes, DNA or DNA/RNA$597.91
- 81275 represents KRAS exon 2 analysis. Code 81445 represents a targeted solid tumor panel that evaluates multiple genes.
- 81235EGFR testingCommon variants$324.58
- 81235 analyzes EGFR variants, while 81275 analyzes KRAS exon 2 variants. Select the code matching the gene analysis performed.
81275 billing questions
When should 81275 be used instead of 81276?
Use 81275 for KRAS exon 2 variants, including codons 12 and 13. Report 81276 as an add-on when additional KRAS variants are analyzed.
Is 81275 a single-gene test or a tumor panel?
It represents KRAS exon 2 analysis. A broader multigene tumor panel, such as 81445, represents analysis of multiple genes.
What documentation supports reporting 81275?
The record should support KRAS exon 2 analysis for the patient's carcinoma biomarker evaluation. The laboratory report should identify the analysis performed.
How does Medicare pay 81275?
Medicare pays 81275 through the CLFS using one national amount across localities, with no office-versus-facility adjustment. The physician fee schedule lists the test as status X.
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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