CPT code 81432: Hereditary cancer panel, breast-related disorders, five or more genes2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A multigene panel analyzes sequence and copy number variants in five or more genes associated with inherited breast cancer-related disorders.
Medicare pays $1,303.95 for 81432 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
$1,303.95
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
- +92.0%
- 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 81432 covers
This panel evaluates genes associated with inherited breast cancer-related disorders, including hereditary breast, ovarian, endometrial, pancreatic, and prostate cancer. The assay analyzes five or more genes for sequence and copy number variants. Clinicians may order it when a patient’s personal or family history raises concern for inherited cancer predisposition; laboratories perform and report the genetic analysis for hereditary risk assessment.
Report the panel service for the qualifying multigene analysis rather than separate services for each gene. The code encompasses sequence-variant and copy-number-variant interrogation. Medicare pays the test through the CLFS at one national amount that applies across localities, with no geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $1,303.95, unchanged from 2025. The test is paid only through the CLFS and is excluded from the physician fee schedule.
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 81432
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 81432. 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 81432 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81432 on the lab fee schedule since 2020
81432 · CLFS 2026 Q4 (current)
$1,303.95
Up 92.0% from $679.05 in 2020
Every change on file
- Jan 1, 2025 · CLFS 2025 Q1$679.05 → $1,303.95 (+92.0%)
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
81432 compared with similar tests
- 81435Colon cancer panelFive or more genes$1,303.95
- 81435 addresses hereditary colon cancer-related disorders; 81432 addresses hereditary breast cancer-related disorders.
- 81445Tumor gene panel5–50 genes, DNA or DNA/RNA$597.91
- 81445 is a somatic neoplasm profiling panel for tumor findings; 81432 analyzes inherited cancer-related risk.
81432 billing questions
When should this code be selected instead of 81435?
Use 81432 for a qualifying panel addressing inherited breast cancer-related disorders. Code 81435 addresses hereditary colon cancer-related disorders.
Does this panel include copy number variant analysis?
Yes. The panel includes interrogation for both sequence variants and copy number variants.
Should each gene in the panel be billed separately?
Report the panel service rather than a separate service for every gene analyzed.
How does Medicare pay this service?
Medicare pays through the CLFS using one national amount across localities, with no office-versus-facility adjustment. The test is excluded from the physician fee schedule.
How does this differ from 81445?
81445 is a somatic neoplasm genomic profiling panel; 81432 addresses inherited cancer-related disorders.
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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