CPT code 81560: Transplant assay, CD154-positive memory cells2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures donor- and third-party-induced memory cells in whole blood to generate a rejection-risk score for pediatric liver or small-bowel allografts.
Medicare pays $640.73 for 81560 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
$640.73
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2023
- 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 81560 covers
81560 measures donor- and third-party-induced CD154-positive cytotoxic memory T cells in whole peripheral blood. An algorithm uses the cell measurements to report a rejection-risk score. The test is used in transplantation medicine to assess allograft rejection risk in pediatric liver and small-bowel transplantation.
Report 81560 for the cell assay and its algorithmic rejection-risk score. Medicare pays it through the Clinical Laboratory Fee Schedule (CLFS), not the physician fee schedule. The 2026 national CLFS amount is $640.73 and has remained unchanged from 2023 through 2025. One amount applies nationwide, with no locality or office/facility adjustment. The test is excluded from the physician fee schedule by statute, so it has no physician-fee-schedule payment.
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 81560
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 81560. 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 81560 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81560 on the lab fee schedule since 2022
81560 · CLFS 2026 Q4 (current)
$640.73
Unchanged since Jan 1, 2023
Every change on file
- Jan 1, 2023 · CLFS 2023 Q1MAC-priced → $640.73
20 quarterly CLFS releases on file, first CLFS 2022 Q1. A code missing from a quarter wasn’t on that release.
81560 compared with similar tests
- 81558Kidney transplant test139-gene mRNA profile$3,240.00
- Choose 81560 for the CD154-positive memory-cell assay used in pediatric liver or small-bowel transplantation. Code 81558 is the kidney-transplant rejection assay.
- 81595Heart transplant testRejection-risk score$3,240.00
- Code 81595 describes an mRNA assay for heart transplantation. Code 81560 is the CD154-positive cell assay for pediatric liver and small-bowel transplantation.
- 81599Unlisted MAAAUnlisted assayNo national amount
- 81599 is an unlisted multianalyte assay code. Code 81560 identifies the CD154-positive cell assay for pediatric liver or small-bowel transplantation.
81560 billing questions
When should 81560 be selected instead of 81558?
81560 is the CD154-positive memory-cell assay for pediatric liver and small-bowel transplantation. Code 81558 describes a kidney-transplant rejection assay.
What does the 81560 result report?
An algorithm reports a rejection-risk score based on measurement of donor- and third-party-induced CD154-positive cytotoxic memory T cells.
What specimen is used for 81560?
The assay uses whole peripheral blood.
Does modifier 26 provide a separate payment for 81560?
The test is paid through the CLFS and is excluded from the physician fee schedule, so it has no separate physician-fee-schedule payment.
How does Medicare price 81560?
Medicare uses one national CLFS amount in every state and locality, with no geographic or office/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
Fee sheets · Coming soon
Put 81560 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist