CPT code 81515: Vaginitis assay, DNA, with BV algorithm2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This vaginal-fluid DNA assay evaluates bacterial vaginosis and vaginitis, reporting a BV likelihood result and separate organism findings when reported.
Medicare pays $262.99 for 81515 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 2025
- 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 81515 covers
This real-time PCR test analyzes vaginal-fluid specimens for DNA markers associated with bacterial vaginosis, including Atopobium vaginae, Atopobium species, Megasphaera type 1, and BVAB-2. Its algorithm reports whether the result indicates a high likelihood of bacterial vaginosis. The assay also includes separate detection of Trichomonas vaginalis and Candida species when reported, including C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis, C. glabrata, and C. krusei. Clinical laboratories perform and report this testing for bacterial vaginosis and vaginitis.
Report 81515 for the DNA-based algorithm; its results may include the BV assessment and separate organism findings. CMS lists a QW version for performance by sites holding a CLIA certificate of waiver. Medicare pays the test through the CLFS, not the physician fee schedule. The 2026 national CLFS amount is $262.99, unchanged from 2025. The amount is the same across localities, without geographic or office-versus-facility adjustment.
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 81515
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 81515. 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 81515 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 81515 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $262.99.
81515 on the lab fee schedule since 2025
81515 · CLFS 2026 Q4 (current)
$262.99
Unchanged since Jan 1, 2025
8 quarterly CLFS releases on file, first CLFS 2025 Q1. A code missing from a quarter wasn’t on that release.
81515 compared with similar tests
- 81513BV RNA assayVaginal fluid, algorithmic result$142.63
- 81515 is the DNA-based bacterial vaginosis and vaginitis algorithm, with separate Trichomonas and Candida detection when reported. 81513 is the RNA-based bacterial vaginosis assay.
- 87661Trichomonas testAmplified nucleic acid$35.09
- Use 87661 for a targeted Trichomonas vaginalis nucleic-acid test. 81515 evaluates bacterial vaginosis and can also include separate Trichomonas detection.
- 87481Candida DNA testAmplified probe$35.09
- Use 87481 for targeted Candida nucleic-acid testing. 81515 is the broader vaginal-fluid algorithm for bacterial vaginosis and vaginitis, with Candida detection when reported.
81515 billing questions
When should a biller distinguish 81515 from 81513?
81515 describes a DNA-based algorithm for bacterial vaginosis and vaginitis. Code 81513 is the RNA-based bacterial vaginosis assay; select the code matching the test performed.
Does 81515 report separate Trichomonas and Candida findings?
The assay includes separate detection of Trichomonas vaginalis and Candida species when those findings are reported. The BV result is reported as positive or negative for a high likelihood of bacterial vaginosis.
When is modifier QW appropriate?
CMS lists a QW version for the CLIA-waived test. It is for sites holding a CLIA certificate of waiver that perform that version.
Is there a separate physician-fee-schedule payment for 81515?
No. Medicare pays this test through the CLFS; it is excluded from the physician fee schedule.
What test details should the record identify?
Identify the vaginal-fluid specimen and DNA-based assay performed, along with the BV result and any separate organism findings reported.
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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