CPT code 81510: Triple screen, AFP, uE3, and hCG2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This maternal serum screen combines AFP, unconjugated estriol, and hCG in an algorithm that reports a risk score for fetal congenital abnormalities.
Medicare pays $55.54 for 81510 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
$55.54
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 81510 covers
81510 identifies a maternal-serum biochemical screen that measures alpha-fetoprotein (AFP), unconjugated estriol (uE3), and human chorionic gonadotropin (hCG), then combines the results in an algorithm to report a risk score for fetal congenital abnormalities. The code distinguishes this three-analyte risk-score service from related prenatal screening assays with different analyte counts or targets.
Report 81510 for the combined three-analyte algorithmic screen; the reported result is a risk score based on the marker results. Medicare pays 81510 only through the CLFS, at one national amount that applies across states and localities without geographic or office/facility adjustment. The 2026 national CLFS amount is $55.54, unchanged each year from 2020 through 2026. The physician fee schedule excludes the test by statute.
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 81510
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 81510. 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 81510 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81510 on the lab fee schedule since 2020
81510 · CLFS 2026 Q4 (current)
$55.54
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.
81510 compared with similar tests
- 81509Prenatal screenThree-protein algorithm$1,487.37
- 81509 identifies a three-protein assay. Use 81510 when the performed test combines AFP, unconjugated estriol, and hCG in a maternal serum algorithm.
- 81511Prenatal screenFour-analyte risk score$153.50
- 81511 is the related four-analyte screen. Choose according to the analytes included in the performed assay, not simply the shared screening purpose.
- 81507Trisomy screeningTrisomies 21, 18, and 13$795.00
- 81507 is identified as a fetal trisomy risk test; 81510 is the maternal serum biochemical screen using AFP, uE3, and hCG for a fetal congenital abnormality risk score.
81510 billing questions
Which markers identify 81510?
This code identifies a maternal serum algorithm using AFP, unconjugated estriol, and hCG. Related fetal congenital abnormality screening codes have different analyte counts or assay descriptions.
How does 81510 differ from 81509?
Both relate to fetal congenital abnormality screening, but 81510 identifies the AFP, uE3, and hCG analyte combination. Code 81509 describes a three-protein assay, so the number three alone does not distinguish them.
What result does 81510 represent?
It represents a combined three-analyte screen that uses an algorithm to report a risk score for fetal congenital abnormalities.
How does Medicare pay for 81510?
Medicare pays the test through the CLFS at one national amount across states and localities, without geographic or office/facility adjustment. The physician fee schedule excludes it by statute.
How does 81510 differ from 81507?
81510 combines maternal serum biochemical markers for a fetal congenital abnormality risk score; 81507 is identified as a fetal trisomy risk test. Select the code that matches the test performed.
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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