CPT code 81451: RNA gene panel, hematolymphoid, 5–50 genes2026 Medicare lab fee · Clinical Laboratory Fee Schedule
RNA-based genomic analysis of 5–50 genes associated with hematolymphoid neoplasms or disorders, reported when this panel analysis is performed.
Medicare pays $759.53 for 81451 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
$759.53
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 81451 covers
This panel analyzes RNA from 5–50 genes associated with hematolymphoid neoplasms or disorders. Depending on the assay, analysis may identify sequence variants, copy-number changes or rearrangements, and differences in isoform or messenger RNA expression. A clinical laboratory performs and reports the assay.
Report 81451 for an RNA analysis panel in the 5–50-gene range. The panel code represents the analysis, not a separate charge for each gene. Medicare pays it through the CLFS, with one national amount across localities and no office-versus-facility payment difference. The 2026 national CLFS amount is $759.53, unchanged from 2023. The test is paid only from 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 81451
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 81451. 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 81451 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81451 on the lab fee schedule since 2023
81451 · CLFS 2026 Q4 (current)
$759.53
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.
81451 compared with similar tests
- 81450Hematolymphoid panel5–50 genes, DNA or combined$759.53
- Both apply to hematolymphoid panels of 5–50 genes. Use 81451 for RNA analysis; 81450 represents DNA analysis, alone or with RNA.
- 81449Tumor RNA Panel5–50 genes, RNA analysis$597.91
- This is the 5–50-gene RNA panel for solid tumors. Use 81451 when the neoplasm or disorder is hematolymphoid.
- 81456RNA tumor panel51 or more genes$2,919.60
- This code covers RNA analysis for solid or hematolymphoid tumors when the panel includes 51 or more genes; 81451 is limited to 5–50.
- 81455Tumor genomic panel51+ genes, DNA or DNA/RNA$2,919.60
- This code covers solid or hematolymphoid panels of 51 or more genes using DNA analysis alone or with RNA. Code 81451 is for a 5–50-gene hematolymphoid RNA panel.
81451 billing questions
When should 81451 be selected instead of 81450?
Use 81451 when the hematolymphoid panel is RNA analysis. Code 81450 is the corresponding 5–50-gene hematolymphoid panel involving DNA analysis, alone or with RNA.
Does 81451 describe DNA testing as well as RNA testing?
No. This code describes RNA analysis. Choose a code that reflects the actual analytes and methods when the panel also includes DNA analysis.
Is the code reported once per gene?
No. It represents the qualifying 5–50-gene panel, not individual gene-level charges. The laboratory report should support the panel’s gene count and RNA analysis.
How does Medicare pay for 81451?
Medicare pays the test through the CLFS at one national amount applicable across localities and settings. It is excluded from the physician fee schedule.
How does 81451 differ from 81449?
Both describe RNA analysis of 5–50 genes, but 81451 is for hematolymphoid neoplasms or disorders; 81449 is for solid tumors.
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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