CPT code 81455: Tumor genomic panel, 51+ genes, DNA or DNA/RNA2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports genomic profiling of a solid organ or hematolymphoid neoplasm using DNA or combined DNA and RNA analysis across 51 or more genes.
Medicare pays $2,919.60 for 81455 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
$2,919.60
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
- 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 81455 covers
This code identifies genomic sequence analysis for a solid organ or hematolymphoid neoplasm or disorder when the panel covers at least 51 genes. The assay may use DNA alone or combined DNA and RNA. Depending on the panel, analysis can evaluate sequence variants, copy-number changes, rearrangements, and, when included, RNA isoform or messenger RNA expression levels. Molecular laboratories report this service for qualifying panels; the gene threshold and assay type distinguish it from smaller neoplasm panels and RNA-only testing.
Medicare pays the test through the CLFS. The 2026 national CLFS amount is $2,919.60, and the same national amount applies across states and localities, without an office-versus-facility difference. The amount has remained unchanged from 2020 through 2026. The code is excluded from the physician fee schedule by statute, and the test 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 81455
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 81455. 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 81455 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81455 on the lab fee schedule since 2020
81455 · CLFS 2026 Q4 (current)
$2,919.60
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
81455 compared with similar tests
- 81445Tumor gene panel5–50 genes, DNA or DNA/RNA$597.91
- This code is for solid organ neoplasms with a 5–50-gene DNA or combined DNA/RNA panel; 81455 requires 51 or more genes.
- 81450Hematolymphoid panel5–50 genes, DNA or combined$759.53
- This code is for hematolymphoid neoplasms with a 5–50-gene DNA or combined DNA/RNA panel; 81455 requires 51 or more genes.
- 81456RNA tumor panel51 or more genes$2,919.60
- Both cover neoplasm panels of 51 or more genes, but 81456 is for RNA analysis; 81455 is for DNA or combined DNA and RNA analysis.
- 81451RNA gene panelHematolymphoid, 5–50 genes$759.53
- This code is for RNA analysis of 5–50 genes in a hematolymphoid neoplasm; 81455 covers DNA or combined DNA/RNA analysis of 51 or more genes.
81455 billing questions
When does this code fit instead of a 5–50-gene neoplasm panel?
Use this code when the qualifying panel analyzes 51 or more genes. The 5–50-gene codes differ according to whether the neoplasm is solid organ or hematolymphoid and whether the assay analyzes DNA, combined DNA and RNA, or RNA.
Does this code include RNA analysis?
It covers DNA analysis or combined DNA and RNA analysis. For a 51-or-more-gene panel based on RNA analysis, compare code 81456.
What can the panel analyze?
The panel can evaluate sequence variants, copy-number changes, and rearrangements. It may also assess RNA isoform or messenger RNA expression levels.
How does Medicare pay for this test?
Medicare pays it through the CLFS at one national amount applicable across localities and care settings. The code is excluded from the physician fee schedule by statute.
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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