CPT code 81507: Trisomy screening, trisomies 21, 18, and 132026 Medicare lab fee · Clinical Laboratory Fee Schedule
This maternal-plasma DNA assay estimates fetal trisomy 21, 18, and 13 risk and reports a separate algorithm-derived risk score for each.
Medicare pays $795.00 for 81507 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
$795.00
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 81507 covers
81507 identifies a maternal-plasma DNA assay that evaluates selected DNA regions and applies an algorithm to estimate fetal risk for trisomies 21, 18, and 13, with a separate risk score for each. It is used in prenatal aneuploidy screening; obstetric and maternal-fetal medicine clinicians may order it during prenatal care, and a laboratory performing the analysis reports the test.
Medicare pays 81507 through the CLFS. The 2026 national amount is $795.00, unchanged from 2020 through 2026. One amount applies across states and localities, with no geographic or office/facility adjustment. The test is excluded from the physician fee schedule and paid only through the CLFS. The assay reports three risk scores, one for each trisomy.
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 81507
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 81507. 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 81507 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81507 on the lab fee schedule since 2020
81507 · CLFS 2026 Q4 (current)
$795.00
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.
81507 compared with similar tests
- 81508Prenatal Risk AssayTwo Serum Proteins$54.30
- Choose 81507 for maternal-plasma DNA analysis with trisomy-specific risk scores. Code 81508 describes a different prenatal assay for fetal congenital abnormalities.
- 81510Triple screenAFP, uE3, and hCG$55.54
- 81507 estimates risk for trisomies 21, 18, and 13 from maternal-plasma DNA. Code 81510 describes a different prenatal assay for fetal congenital abnormalities.
81507 billing questions
What results does 81507 report?
It reports an algorithm-derived risk score for each of trisomies 21, 18, and 13, based on DNA analysis using maternal plasma.
Do the three risk scores represent separate assays?
No. They are the three results produced by the maternal-plasma DNA analysis represented by 81507.
How does 81507 differ from 81508 or 81510?
81507 is maternal-plasma DNA analysis for trisomy risk. Codes 81508 and 81510 describe different prenatal assays for fetal congenital abnormalities.
How does Medicare pay for 81507?
Medicare pays it through the CLFS at one national amount across localities and settings. The test 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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