CPT code 81435: Colon cancer panel, five or more genes2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This multigene test evaluates inherited colon cancer-related disorders, including Lynch syndrome and polyposis syndromes, by analyzing sequence and copy number variants.
Medicare pays $1,303.95 for 81435 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
- +122.9%
- 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 81435 covers
This multigene panel evaluates inherited colon cancer-related disorders, including Lynch syndrome, PTEN hamartoma syndrome (Cowden syndrome), and familial adenomatous polyposis. It analyzes five or more genes for sequence variants and copy number variants. The service is genetic testing for hereditary cancer risk; its scope is broader than a single-gene assay and distinct from tumor-only profiling.
Report 81435 for the qualifying panel analysis. Medicare pays the test through the CLFS at one national amount that applies across states and localities, without an office-versus-facility difference. The 2026 national CLFS amount is $1,303.95; it increased in 2025 from the amount maintained during 2020–2024 and remained unchanged in 2026. The code is excluded from the physician fee schedule by statute and is paid only through the CLFS.
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 81435
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 81435. 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 81435 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81435 on the lab fee schedule since 2020
81435 · CLFS 2026 Q4 (current)
$1,303.95
Up 122.9% from $584.90 in 2020
Every change on file
- Jan 1, 2025 · CLFS 2025 Q1$584.90 → $1,303.95 (+122.9%)
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
81435 compared with similar tests
- 81432Hereditary cancer panelBreast-related disorders, five or more genes$1,303.95
- Select 81432 for a qualifying panel for inherited breast cancer-related disorders; 81435 addresses inherited colon cancer-related disorders.
- 81437Neuroendocrine panelFive or more genes$1,303.95
- Select 81437 for a qualifying panel for hereditary neuroendocrine tumor-related disorders, rather than the colon cancer-related disorders addressed by 81435.
- 81445Tumor gene panel5–50 genes, DNA or DNA/RNA$597.91
- 81445 describes a solid tumor oncology genomic panel. Code 81435 is for inherited cancer-related testing, not tumor-only profiling.
81435 billing questions
When should this code be selected instead of a single-gene test?
Use it for a hereditary colon cancer-related panel of five or more genes that evaluates sequence and copy number variants. A single-gene assay has a different scope.
Which kinds of variants does this panel evaluate?
It evaluates sequence variants and copy number variants across the panel.
Does this code describe tumor-only sequencing?
No. It describes testing for inherited colon cancer-related disorders, rather than tumor-only profiling.
Is a separate physician interpretation paid with modifier 26?
Medicare pays this test only through the CLFS; the code is excluded from the physician fee schedule.
How does Medicare price this test?
Medicare pays one national CLFS amount 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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