CPT code 81558: Kidney transplant test, 139-gene mRNA profile2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This whole-blood mRNA test profiles 139 genes associated with kidney transplant rejection and reports a binary assessment of immune quiescence or subclinical rejection.
Medicare pays $3,240.00 for 81558 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
$3,240.00
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2025
- 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 81558 covers
This assay analyzes mRNA expression across 139 genes associated with kidney allograft rejection using quantitative PCR on whole blood. Its algorithm reports one of two categories: “transplant excellence,” indicating immune quiescence, or “not transplant excellence,” indicating subclinical rejection. It is used in kidney transplant care to assess rejection-related gene-expression patterns.
Report 81558 for this defined kidney transplant gene-expression assay. Medicare pays it through the CLFS, with one national amount in every state and locality and no office or facility payment difference. The 2026 national CLFS amount is $3,240.00, unchanged from 2025. The test is excluded from the physician fee schedule by statute and 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 81558
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 81558. 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 81558 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81558 on the lab fee schedule since 2025
81558 · CLFS 2026 Q4 (current)
$3,240.00
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.
81558 compared with similar tests
- 81560Transplant assayCD154-positive memory cells$640.73
- Use 81558 for the 139-gene kidney transplant mRNA assay. 81560 is associated with a different transplant assay for liver and bowel transplantation.
- 81595Heart transplant testRejection-risk score$3,240.00
- 81558 is specific to kidney transplant rejection; 81595 is associated with heart transplantation.
81558 billing questions
Which specimen is used for this assay?
The assay uses whole blood and profiles mRNA expression across 139 genes associated with kidney transplant rejection.
What result does the assay report?
Its algorithm reports “transplant excellence,” indicating immune quiescence, or “not transplant excellence,” indicating subclinical rejection.
How does 81558 differ from 81560?
81558 is the 139-gene mRNA profile for kidney allograft rejection. 81560 is a different transplant assay associated with liver and bowel transplantation.
How does 81558 differ from 81595?
81558 evaluates kidney transplant rejection using a 139-gene mRNA profile. 81595 is associated with heart transplantation.
How does Medicare pay for 81558?
Medicare pays 81558 through the CLFS only, using one national amount in every state and locality, with no office or facility payment difference.
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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