CPT code 81513: BV RNA assay, vaginal fluid, algorithmic result2026 Medicare lab fee · Clinical Laboratory Fee Schedule
An RNA amplification assay evaluates vaginal-fluid markers and reports an algorithmic positive or negative result for bacterial vaginosis.
Medicare pays $142.63 for 81513 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
$142.63
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2021
- 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 81513 covers
81513 identifies bacterial vaginosis through quantitative real-time amplification of RNA markers in a vaginal-fluid specimen. The assay evaluates markers associated with Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species and combines them into an algorithmic positive or negative BV result, rather than separate results for each marker. This distinguishes the service from a broader DNA-based BV-and-vaginitis assay. The laboratory reports the molecular test result for the ordering clinician.
Report 81513 for the assay performed on vaginal fluid. The RNA markers are inputs to the algorithmic result, not separate services described by this code. Medicare pays the test under the CLFS at one national amount across localities, without an office-versus-facility payment difference. The 2026 national CLFS amount is $142.63, unchanged from 2021 through 2026. The test is paid through the CLFS and is excluded from the physician fee schedule.
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 81513
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 81513. 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 81513 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81513 on the lab fee schedule since 2021
81513 · CLFS 2026 Q4 (current)
$142.63
Unchanged since Jan 1, 2021
24 quarterly CLFS releases on file, first CLFS 2021 Q1. A code missing from a quarter wasn’t on that release.
81513 compared with similar tests
- 81514Vaginitis assayDNA algorithm, BV and vaginitis$262.99
- 81513 uses RNA markers for an algorithmic BV result. 81514 describes DNA-based testing for BV and vaginitis.
- 81515Vaginitis assayDNA, with BV algorithm$262.99
- 81515 describes DNA-based testing for BV and vaginitis; 81513 is the RNA-based assay with an algorithmic BV result.
- 87510Gardnerella testDirect probe technique$20.05
- 87510 detects Gardnerella vaginalis by nucleic acid probe. It does not provide the algorithmic bacterial vaginosis result reported by 81513.
81513 billing questions
When should 81513 be selected instead of a broader vaginitis assay?
Use 81513 for the RNA-based assay that reports an algorithmic positive or negative result for bacterial vaginosis. Codes 81514 and 81515 describe DNA-based BV-and-vaginitis testing.
Does 81513 report individual organism results?
No. The assay evaluates RNA markers associated with Atopobium vaginae, Gardnerella vaginalis, and Lactobacillus species, then reports an algorithmic BV result.
What specimen does 81513 describe?
The assay uses a vaginal-fluid specimen.
How many units are reported?
Report 81513 for the assay performed. Its RNA markers are inputs to the algorithmic result, not separately reported services under this code.
How does Medicare pay for 81513?
Medicare pays 81513 through the CLFS at one national rate, without geographic or office-versus-facility variation. 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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