CPT code 81288: MLH1 methylation, promoter analysis2026 Medicare lab fee · Clinical Laboratory Fee Schedule
MLH1 promoter methylation analysis is a molecular test for a gene associated with colon cancer, reported when this specific gene feature is tested.
Medicare pays $192.32 for 81288 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
$192.32
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 81288 covers
CPT 81288 identifies analysis of promoter methylation in MLH1, a gene associated with colon cancer. The service focuses on a promoter methylation finding rather than MLH1 full-gene sequencing, testing for known MLH1 variants, or deletion/duplication variant analysis. Those are distinct MLH1 testing services represented by codes 81292, 81293, and 81294, respectively. The reported service is promoter methylation analysis, not a combined MLH1 sequencing, known-variant, or deletion/duplication analysis.
Medicare pays 81288 only through the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $192.32, the same amount across states and localities and in office and facility settings. The national amount has been unchanged since 2020. The code is excluded from the physician fee schedule by statute.
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 81288
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 81288. 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 81288 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81288 on the lab fee schedule since 2020
81288 · CLFS 2026 Q4 (current)
$192.32
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.
81288 compared with similar tests
- 81292MLH1 testingFull sequence$675.40
- Choose 81288 for MLH1 promoter methylation analysis; choose 81292 for full MLH1 gene sequencing.
- 81293MLH1 variant testKnown familial variants$331.00
- Code 81293 identifies MLH1 known-variant testing. Code 81288 identifies promoter methylation analysis.
- 81294MLH1 analysisDuplication and deletion variants$202.40
- Code 81294 identifies MLH1 deletion/duplication variant analysis; 81288 identifies promoter methylation analysis.
81288 billing questions
When should 81288 be selected instead of an MLH1 sequencing code?
Use 81288 for MLH1 promoter methylation analysis. Full-gene sequencing, known-variant testing, and deletion/duplication analysis are distinct services.
Which code identifies full MLH1 gene sequencing?
Code 81292 identifies MLH1 full-gene sequencing, rather than promoter methylation analysis.
How does 81288 differ from MLH1 known-variant testing?
Code 81288 is for promoter methylation analysis; code 81293 is for MLH1 known-variant testing.
How does Medicare pay for 81288?
Medicare pays 81288 through the CLFS, with one national amount across localities and office and facility settings.
Is 81288 the code for MLH1 deletion or duplication analysis?
No. Code 81294 identifies MLH1 deletion/duplication variant analysis; 81288 identifies promoter methylation analysis.
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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