CPT code 81437: Neuroendocrine panel, five or more genes2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A multigene analysis for inherited neuroendocrine tumor disorders, reported when testing evaluates sequence and copy number variants across five or more genes.
Medicare pays $1,303.95 for 81437 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
- +197.1%
- 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 7 sections
What 81437 covers
81437 represents genetic testing for inherited neuroendocrine tumor conditions. The analysis looks for sequence changes and copy-number changes in at least five genes associated with conditions such as medullary thyroid carcinoma, parathyroid carcinoma, and malignant pheochromocytoma or paraganglioma. A clinical laboratory performs and reports the analysis.
Report 81437 for the qualifying panel rather than separately reporting each gene in the panel. Medicare pays the test through the CLFS only. The 2026 national CLFS amount is $1,303.95, unchanged from 2025 after lower amounts from 2020 through 2024. The same amount applies in every locality, with no geographic or office-versus-facility adjustment. The test is excluded from the physician fee schedule and 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 81437
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 81437. 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 81437 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81437 on the lab fee schedule since 2020
81437 · CLFS 2026 Q4 (current)
$1,303.95
Up 197.1% from $438.93 in 2020
Every change on file
- Jan 1, 2025 · CLFS 2025 Q1$438.93 → $1,303.95 (+197.1%)
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
81437 compared with similar tests
- 81432Hereditary cancer panelBreast-related disorders, five or more genes$1,303.95
- Choose 81432 for hereditary breast cancer-related disorders; 81437 targets inherited neuroendocrine tumor-related disorders.
- 81435Colon cancer panelFive or more genes$1,303.95
- Choose 81435 for hereditary colon cancer-related disorders. 81437 is directed to inherited neuroendocrine tumor-related disorders.
- 81425Genome sequencingConstitutional or heritable disorders$5,031.20
- 81425 is for genome sequence analysis. 81437 identifies a panel for inherited neuroendocrine tumor-related disorders, with sequence and copy number variant analysis.
81437 billing questions
When is 81437 the appropriate hereditary panel?
Use it for a panel analyzing five or more genes associated with inherited neuroendocrine tumor-related disorders, including the listed endocrine tumors. The panel evaluates sequence and copy number variants.
How does 81437 differ from 81435?
81437 targets inherited neuroendocrine tumor-related disorders. 81435 is the hereditary colon cancer-related disorder panel.
Should each gene in the panel be billed separately?
Report 81437 for the qualifying multigene panel, not as a separate service for each gene analyzed.
How does Medicare pay 81437?
Medicare pays 81437 through the CLFS only, using one national amount across localities and settings. It is excluded from the physician fee schedule.
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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