CPT code 81422: Fetal microdeletion test, maternal blood cell-free DNA2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Genomic analysis of cell-free fetal DNA in maternal blood assesses fetal chromosomal microdeletions, including deletions associated with DiGeorge or cri-du-chat syndrome.
Medicare pays $759.05 for 81422 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
$759.05
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 81422 covers
Code 81422 represents genomic analysis of circulating cell-free fetal DNA in maternal blood for fetal chromosomal microdeletions associated with disease. Examples include deletions associated with DiGeorge syndrome and cri-du-chat syndrome. Obstetricians and maternal-fetal medicine clinicians may order this prenatal test when microdeletion assessment is intended; clinical molecular laboratories perform and report the analysis. It addresses microdeletion findings, not the fetal aneuploidy targets assessed by a separate assay.
Report the code for the microdeletion analysis performed, with the order and laboratory report supporting that target. The 2026 national CLFS amount is $759.05, unchanged in each year from 2020 through 2026. Medicare pays one national amount per code across all states and localities, without geographic or office-versus-facility adjustment. The test is paid through the CLFS only, with no physician fee schedule payment for the test.
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 81422
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 81422. 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 81422 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81422 on the lab fee schedule since 2020
81422 · CLFS 2026 Q4 (current)
$759.05
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.
81422 compared with similar tests
- 81420Fetal aneuploidyMaternal blood, genomic panel$759.05
- Choose 81420 for fetal chromosomal aneuploidy analysis. Use 81422 when the analysis targets fetal chromosomal microdeletions.
- 81415Exome analysisInitial sequence analysis$4,780.00
- 81415 is exome sequence analysis, not targeted prenatal microdeletion analysis of cell-free fetal DNA in maternal blood.
- 81412Disorder gene panelAshkenazi-associated conditions$2,448.56
- 81412 concerns testing for Ashkenazi Jewish-associated disorders; 81422 analyzes fetal microdeletions using maternal blood cell-free DNA.
81422 billing questions
How does 81422 differ from 81420?
81422 is for fetal chromosomal microdeletion analysis in maternal blood cell-free DNA. 81420 addresses fetal chromosomal aneuploidy, a different testing target.
What specimen does this test analyze?
The analysis uses circulating cell-free fetal DNA in maternal blood.
How does Medicare pay for 81422?
Medicare pays the test through the CLFS at one national amount per code, without geographic or office-versus-facility adjustment.
What supports reporting 81422?
The documentation should identify the prenatal microdeletion analysis and include the laboratory report confirming the test performed.
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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