CPT code 81449: Tumor RNA Panel, 5–50 genes, RNA analysis2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This panel analyzes RNA across 5–50 genes associated with solid organ neoplasms, with variant and rearrangement interrogation when performed.
Medicare pays $597.91 for 81449 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
$597.91
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2023
- 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 81449 covers
This code identifies genomic sequence analysis of RNA from a solid organ neoplasm using a panel of 5–50 genes. The assay interrogates sequence variants and may include copy number variants or rearrangements when performed. It distinguishes this RNA analysis from solid-neoplasm panels that analyze DNA or combined DNA and RNA, and from RNA panels for hematologic neoplasms or panels covering 51 or more genes.
Medicare pays the test under the CLFS at one national amount across states and localities, with no geographic adjustment or office/facility difference. The 2026 national CLFS amount is $597.91, unchanged from 2023 through 2026. The physician fee schedule excludes the test by statute; it 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 81449
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 81449. 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 81449 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81449 on the lab fee schedule since 2023
81449 · CLFS 2026 Q4 (current)
$597.91
Unchanged since Jan 1, 2023
16 quarterly CLFS releases on file, first CLFS 2023 Q1. A code missing from a quarter wasn’t on that release.
81449 compared with similar tests
- 81445Tumor gene panel5–50 genes, DNA or DNA/RNA$597.91
- Both address solid-neoplasm panels in the 5–50-gene range. Choose this code for RNA analysis; 81445 describes DNA analysis or combined DNA and RNA analysis.
- 81451RNA gene panelHematolymphoid, 5–50 genes$759.53
- Both describe RNA panels covering 5–50 genes. This code is for solid organ neoplasms; 81451 is for hematologic neoplasms.
- 81456RNA tumor panel51 or more genes$2,919.60
- Code 81456 describes RNA panels of 51 or more genes associated with solid or hematologic neoplasms. This code covers 5–50 genes associated with solid organ neoplasms.
- 81455Tumor genomic panel51+ genes, DNA or DNA/RNA$2,919.60
- Code 81455 describes panels of 51 or more genes associated with solid or hematologic neoplasms, using DNA or combined DNA and RNA analysis. This code describes RNA analysis of 5–50 genes associated with solid organ neoplasms.
81449 billing questions
When does 81445 differ from this code?
Both cover solid-neoplasm panels in the 5–50-gene range. This code describes RNA analysis; 81445 describes DNA analysis or combined DNA and RNA analysis.
How does this code differ from 81451?
Both describe RNA panels covering 5–50 genes. This code is for solid organ neoplasms, while 81451 is for hematologic neoplasms.
Which code covers an RNA panel with 51 or more genes?
Code 81456 describes RNA analysis for panels of 51 or more genes associated with solid or hematologic neoplasms.
How does Medicare pay for this test?
Medicare pays it through the CLFS at one national amount across localities, with no office or facility payment difference. The test is paid only through the CLFS.
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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