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Current CMS pricing and breakdown for Str markers specimen anal.
Non-Facility (Private Office) Rate
| Quarter | Q2 2025 | Q3 2025 | Q4 2025 | Q1 2026 | Q2 2026 | Q3 2026 |
|---|---|---|---|---|---|---|
| National Average Payment | $233.07 | $233.07 | $233.07 | $233.07 | $233.07 | $233.07 |
This item has a standard price nationwide. Your local rate will likely match the amount shown above.
Comparative analysis using short tandem repeat (str) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient germline [eg, buccal swab or other germline tissue sample] and donor testing, twin zygosity testing, or maternal cell contamination of fetal cells)
CPT code 81265 (Comparative analysis using short tandem repeat (str) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient germline [eg, buccal swab or other germline tissue sample] and donor testing, twin zygosity testing, or maternal cell contamination of fetal cells)) had a 2026 Medicare non-facility reimbursement rate of $233.07. This reflects a 0.00% change from the prior year.
The 2026 National Medicare reimbursement for 81265 is $233.07. This item is paid at a standard national rate, so local variation is typically minimal.
Description: Comparative analysis using short tandem repeat (str) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-tr.... Payment policies and coverage rules can still vary by setting and claim details, so confirm final guidance through CMS when needed.
| Quarter | Q2 2025 | Q3 2025 | Q4 2025 | Q1 2026 | Q2 2026 | Q3 2026 |
|---|---|---|---|---|---|---|
| National Average Payment | $233.07 | $233.07 | $233.07 | $233.07 | $233.07 | $233.07 |
| Quarter | Non-Facility Rate | Facility Rate | YoY % Change (Non-Fac) | YoY % Change (Fac) |
|---|---|---|---|---|
| 2026 Q3 | $233.07 | $233.07 | +0.00% | +0.00% |
| 2026 Q2 | $233.07 | $233.07 | +0.00% | +0.00% |
| 2026 Q1 | $233.07 | $233.07 | +0.00% | +0.00% |
| 2025 Q4 | $233.07 | $233.07 | — | — |
| 2025 Q3 | $233.07 | $233.07 | — | — |
| 2025 Q2 | $233.07 | $233.07 | — | — |
| 2025 Q1 | $233.07 | $233.07 | — | — |
| Component | Office (Non-Fac) | Facility (Hosp) |
|---|---|---|
| Work RVU | ||
| Practice Expense (PE) | ||
| Malpractice (MP) | ||
| Total RVUs | 0.00 | 0.00 |
Compare a payment against the Medicare benchmark for this code.
Medicare rates are used as a benchmark only. Actual payer contracts, modifiers, place of service, units, and billing rules may affect reimbursement. This tool is for educational and operational review purposes, not legal or billing advice.
National average reimbursement from major commercial payers based on CMS Transparency in Coverage machine-readable files.
| Modifier | Place of Service | Avg. Rate | vs Medicare | Percentile Range |
|---|---|---|---|---|
| NULL | Office (11) | $91.46 | -4.0% | $80 — $104 |
| NULL | Telehealth (02) | $88.20 | -7.4% | $76 — $102 |
| NULL | Facility (21) | $79.31 | -15.6% | $68 — $95 |
| NULL | Outpatient Hospital (22) | $84.92 | -10.2% | $71 — $99 |
| NULL | Home (12) | $96.14 | +1.0% | $84 — $113 |
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Source: CMS Transparency in Coverage machine-readable files (MRFs). Commercial rates reflect payer-published negotiated amounts and may not reflect individual contracted rates.
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Facility vs. non-facility pricing most commonly applies to physician services paid under the RVU-based Physician Fee Schedule. For 81265 (Clinical Laboratory Test), the payment methodology may not include both facility and non-facility rates.
Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.
The 2026 National Average Medicare reimbursement rate for 81265 (Clinical Laboratory Test) is $233.07. This rate is effective as of January 1, 2026.
Comparative analysis using short tandem repeat (str) markers; patient and comparative specimen (eg, pre-transplant recipient and donor germline testing, post-transplant non-hematopoietic recipient germline [eg, buccal swab or other germline tissue sample] and donor testing, twin zygosity testing, or maternal cell contamination of fetal cells)
Facility vs. non-facility differences usually apply to RVU-based physician services. 81265 may not use both facility and non-facility pricing depending on its payment methodology.
Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.
Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.