CPT code 81541: Prostate profile, 46-gene mortality score2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This prostate tumor tissue assay profiles mRNA expression across 46 genes and reports an algorithm-derived disease-specific mortality risk score.
Medicare pays $3,873.00 for 81541 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
$3,873.00
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 81541 covers
81541 covers molecular profiling of prostate tumor tissue by real-time reverse-transcription polymerase chain reaction (RT-PCR). The assay evaluates mRNA expression across 46 genes: 31 content genes and 15 housekeeping genes. It uses formalin-fixed, paraffin-embedded tissue and produces an algorithm-derived disease-specific mortality risk score. The code identifies this 46-gene profile rather than a general prostate tumor molecular test.
Report 81541 for this profile. Medicare pays it under the CLFS at one nationally set amount that applies across states and localities, without an office or facility payment difference. The 2026 national amount is $3,873.00, unchanged since 2020. The test is excluded from the physician fee schedule by statute and paid only through 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 81541
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 81541. 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 81541 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81541 on the lab fee schedule since 2020
81541 · CLFS 2026 Q4 (current)
$3,873.00
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.
81541 compared with similar tests
- 81539Prostate risk scoreFour-protein probability score$760.00
- 81541 is the 46-gene mRNA profile with a disease-specific mortality risk score. 81539 describes a different prostate prognostic score assay.
- 81542Prostate genomic test22-gene metastasis risk profile$3,873.00
- Both are prostate mRNA profiles, but 81541 is identified by a 46-gene count and 81542 by a 22-gene count.
- 81551Prostate assayThree-gene methylation$2,030.00
- 81551 identifies a prostate oncology assay by a three-gene count; 81541 is the 46-gene mRNA profile.
81541 billing questions
What specimen does this assay analyze?
It analyzes formalin-fixed, paraffin-embedded prostate tumor tissue.
What does the 46-gene profile measure?
It profiles mRNA expression across 31 content genes and 15 housekeeping genes using real-time RT-PCR.
What result does 81541 report?
The assay produces an algorithm-derived disease-specific mortality risk score.
How does 81541 differ from 81539?
81541 identifies a 46-gene mRNA profile with a disease-specific mortality risk score. 81539 identifies a different prostate prognostic score assay.
How does Medicare pay for 81541?
Medicare pays it only under the CLFS at one national amount per code, with no geographic or office or facility payment 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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