CPT code 81514: Vaginitis assay, DNA algorithm, BV and vaginitis2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A vaginal-fluid DNA assay assesses bacterial vaginosis likelihood and can separately detect Candida species and Trichomonas vaginalis when reported.
Medicare pays $262.99 for 81514 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
$262.99
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
- QW · CLIA-waived test
- $262.99
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 81514 covers
This test measures vaginal-fluid DNA markers associated with bacterial vaginosis, including Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, BVAB-2, and Lactobacillus species. An algorithm reports a positive or negative result for a high likelihood of bacterial vaginosis. When reported, the assay also separately detects Trichomonas vaginalis and Candida species, including C. glabrata and C. krusei. Clinicians may order it when evaluating vaginal discharge, odor, or irritation for bacterial vaginosis or infectious vaginitis.
For its CLIA-waived version, modifier QW identifies the waived test performed by a site holding a CLIA certificate of waiver. Medicare pays the test under the CLFS at one national amount in every locality, without geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $262.99, unchanged from 2021 through 2026. 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 81514
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 81514. 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 81514 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 81514 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $262.99.
81514 on the lab fee schedule since 2021
81514 · CLFS 2026 Q4 (current)
$262.99
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.
81514 compared with similar tests
- 81513BV RNA assayVaginal fluid, algorithmic result$142.63
- Both use a vaginal-fluid algorithm to assess bacterial vaginosis, but 81513 uses RNA markers; 81514 uses DNA markers and can separately detect Candida or Trichomonas when reported.
- 87511Gardnerella testAmplified probe$35.09
- Code 87511 detects Gardnerella vaginalis specifically. Code 81514 uses multiple DNA markers in an algorithm to assess bacterial vaginosis likelihood and may report additional pathogen detections.
- 87481Candida DNA testAmplified probe$35.09
- Code 87481 is a Candida nucleic acid test. Code 81514 is the broader bacterial vaginosis and vaginitis assay, with Candida detection when reported.
- 87661Trichomonas testAmplified nucleic acid$35.09
- Code 87661 targets Trichomonas vaginalis. Code 81514 assesses bacterial vaginosis likelihood and may also report Trichomonas detection as part of the assay.
81514 billing questions
How does this assay differ from 81513?
Code 81514 uses DNA markers for bacterial vaginosis and vaginitis. Code 81513 uses RNA markers for bacterial vaginosis.
What specimen does the assay analyze?
It measures DNA markers in vaginal fluid.
When is modifier QW appropriate?
Use QW for the CLIA-waived version performed by a site holding a CLIA certificate of waiver.
What additional organisms may the assay detect?
When reported, it separately detects Trichomonas vaginalis and Candida species, including C. glabrata and C. krusei.
How does Medicare pay this test?
Medicare pays it under the CLFS using one national amount across localities, with no office-versus-facility adjustment.
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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