CPT code 81318: PMS2 testing, known familial variants2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Targeted PMS2 testing identifies a previously established familial variant during hereditary cancer evaluation, including evaluation for Lynch syndrome.
Medicare pays $331.00 for 81318 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
$331.00
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 81318 covers
This service analyzes PMS2 for variant(s) already identified in the family, rather than sequencing the full gene or assessing PMS2 for duplication or deletion variants. PMS2 is associated with Lynch syndrome, also called hereditary nonpolyposis colorectal cancer. Targeted testing is used in hereditary cancer evaluation when a familial PMS2 variant is known. The result addresses the familial variant(s) being tested, distinguishing this service from broader PMS2 analysis.
Report 81318 for targeted analysis of known familial PMS2 variant(s). Medicare pays the test through the CLFS at one national amount in every state and locality, with no geographic adjustment or office/facility difference. The 2026 national CLFS amount is $331.00, unchanged since 2020. The service is paid only through the CLFS and has no separate physician fee schedule payment.
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 81318
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 81318. 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 81318 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81318 on the lab fee schedule since 2020
81318 · CLFS 2026 Q4 (current)
$331.00
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.
81318 compared with similar tests
- 81317PMS2 sequencingFull gene sequence$676.50
- 81318 targets known familial PMS2 variant(s); 81317 is for full-gene PMS2 sequence analysis.
- 81319PMS2 analysisDuplication and deletion variants$203.50
- Choose 81318 for known familial PMS2 variants and 81319 for PMS2 duplication or deletion analysis.
- 81293MLH1 variant testKnown familial variants$331.00
- Both address known familial variants, but 81293 is for MLH1 and 81318 is for PMS2.
- 81296MSH2 testingKnown familial variants$337.73
- Both address known familial variants, but 81296 is for MSH2 and 81318 is for PMS2.
81318 billing questions
When should 81318 be selected instead of 81317?
Use 81318 when testing is directed at known familial PMS2 variant(s). Code 81317 describes full-gene PMS2 sequence analysis, a broader service.
How does 81318 differ from 81319?
Code 81318 is for known familial PMS2 variants. Code 81319 is for PMS2 duplication or deletion variant analysis.
Does 81318 report full PMS2 sequencing?
No. It reports targeted analysis of known familial PMS2 variant(s); full-gene sequence analysis is reported with 81317.
How does Medicare pay for this test?
Medicare pays 81318 through the CLFS at one national amount. There is no separate physician fee schedule payment.
What clinical context supports reporting 81318?
The analysis is directed at a PMS2 variant already identified in the family as part of hereditary cancer evaluation.
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
Fee sheets · Coming soon
Put 81318 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist