CPT code 81307: PALB2 test, full gene sequence2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Full-sequence PALB2 analysis is reported when testing evaluates the gene broadly for inherited breast or pancreatic cancer susceptibility.
Medicare pays $676.50 for 81307 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
$676.50
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
- +139.1%
- 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 81307 covers
This molecular genetic test analyzes the full PALB2 gene sequence. PALB2 is involved in DNA repair and associated with inherited susceptibility to breast and pancreatic cancer. Clinicians may order testing during hereditary cancer risk assessment prompted by a patient’s personal or family history. A molecular laboratory performs and reports the analysis.
Report 81307 for full-gene analysis; 81308 is used for testing known familial PALB2 variants. 81307 represents PALB2 analysis rather than a multigene panel. Medicare pays the test only through the CLFS. The 2026 national CLFS amount is $676.50, and the same amount applies across localities and in office and facility settings; it has been unchanged since 2021. The physician fee schedule excludes the test 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 81307
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 81307. 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 81307 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81307 on the lab fee schedule since 2020
81307 · CLFS 2026 Q4 (current)
$676.50
Up 139.1% from $282.88 in 2020
Every change on file
- Jan 1, 2021 · CLFS 2021 Q1$282.88 → $676.50 (+139.1%)
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
81307 compared with similar tests
- 81308PALB2 testingKnown familial variant$301.35
- 81307 covers full-gene PALB2 analysis; 81308 is for known familial PALB2 variants.
- 81432Hereditary cancer panelBreast-related disorders, five or more genes$1,303.95
- 81307 analyzes PALB2 alone. 81432 represents a hereditary breast cancer-related multigene panel when broader testing is ordered.
81307 billing questions
When should 81307 be used instead of 81308?
Use 81307 for full-gene PALB2 analysis. Use 81308 when testing is limited to known familial PALB2 variants.
Does 81307 represent a multigene hereditary cancer panel?
No. It represents analysis of PALB2, not a multigene panel.
How does Medicare pay for 81307?
Medicare pays it through the CLFS at one nationally set amount, with no geographic or office-versus-facility adjustment.
How does 81307 differ from 81432?
81307 is full-sequence analysis of PALB2 alone. 81432 represents a hereditary breast cancer-related multigene panel.
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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