CPT code 81298: MSH6 testing, full sequence analysis2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Full-sequence MSH6 analysis supports evaluation for Lynch syndrome when personal, family, or tumor findings raise concern for inherited cancer risk.
Medicare pays $641.85 for 81298 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
$641.85
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 81298 covers
This test analyzes the full sequence of MSH6, a mismatch-repair gene associated with Lynch syndrome (hereditary nonpolyposis colorectal cancer). It is used in evaluation of suspected inherited cancer risk, including cases where personal or family history or tumor findings prompt assessment for Lynch syndrome. Genetics, oncology, and gastroenterology clinicians may order the test, and a molecular laboratory reports the sequence analysis.
Report 81298 for full-sequence MSH6 analysis, rather than testing limited to known MSH6 variants, which is reported with 81299. Medicare pays this laboratory test under the CLFS only. The 2026 national CLFS amount is $641.85 and is the same across states, localities, and office and facility settings; it has remained unchanged since 2020.
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 81298
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 81298. 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 81298 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81298 on the lab fee schedule since 2020
81298 · CLFS 2026 Q4 (current)
$641.85
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.
81298 compared with similar tests
- 81299MSH6 testingKnown familial variants$308.00
- 81298 analyzes the full MSH6 sequence. Choose 81299 when the analysis is limited to known MSH6 variants.
- 81295MSH2 testingFull gene sequence$381.70
- 81295 analyzes MSH2 rather than MSH6. Select the code for the gene analyzed.
- 81292MLH1 testingFull sequence$675.40
- 81292 analyzes MLH1 rather than MSH6. Select the code for the gene analyzed.
81298 billing questions
When should 81298 be reported instead of 81299?
Use 81298 for full-sequence analysis of MSH6. Code 81299 is for analysis limited to known MSH6 variants.
How does 81298 differ from 81292 and 81295?
81298 analyzes MSH6, 81292 analyzes MLH1, and 81295 analyzes MSH2. Select the code for the gene analyzed.
How is 81298 paid by Medicare?
Medicare pays 81298 through the CLFS. The code is paid only through the CLFS, not the physician fee schedule.
Does Medicare adjust payment for locality or setting?
No. The CLFS amount is the same across states and 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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