CPT procedure code

81403

Medicare payment

$185.20

2026 Clinical Laboratory Fee Schedule

Source: CMS Clinical Laboratory Fee Schedule (2026). CMS fee schedules ↗ · PFS status indicator X

National amount before geographic adjustment. Your MAC's locality rate will differ.

Code definition

Code

81403

Code system

CPT (Current Procedural Terminology)

This CPT code is not in our curated reference. CPT codes are maintained by the American Medical Association (AMA). Full descriptions require an AMA license.

Category

Short description sourced from CMS publicly available fee schedule data. Full CPT descriptions are copyright AMA. Not a substitute for the official CPT codebook.

Policy activity for CPT 81403

CLV Intelligence is tracking 20 policy changes that cite CPT 81403 between 2026-06-05 and 2026-08-27, drawn from 16 LCD/NCD coverage updates, 3 proposed LCDs and 1 MAC LCD revision. The changes span Clinical Laboratory, Infectious Disease / Microbiology, Multi-specialty and Oncology, and 1 more. 14 are flagged critical or high priority.

LCD/NCD coverage updates
16
proposed LCDs
3
MAC LCD revision
1

Counts reflect the source documents CLV has matched to CPT 81403 to date; each links to the government publication that is authoritative. Monitored daily from CMS, the Federal Register, and Medicare Administrative Contractor publications.

Policy changes matched to 81403

Matched to this code by CLV analysis of each policy. The linked source document is authoritative.

Proposed LCD DL40431: MolDX: Genome-Wide Molecular Methodologies for the Detection of Copy Number Alterations and Structural Variants in Hematologic Neoplasms — CGS

Oncology · LCD-DL40431

Government source· CMS / MACverify ↗
Critical

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Proposed LCD DL40407: MolDX: Genome-Wide Molecular Methodologies for the Detection of Copy Number Alterations and Structural Variants in Hematologic Neoplasms — Palmetto GBA

Oncology · LCD-DL40407

Government source· CMS / MACverify ↗
Critical

Full analysis available with a CLV subscription.

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LCD L38586: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer — CGS Administrators

Oncology · LCD-L38586

Government source· CMS / MACverify ↗
High

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LCD L38576: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer — Palmetto GBA

Urology · LCD-L38576

Government source· CMS / MACverify ↗
High

Full analysis available with a CLV subscription.

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LCD L36021: MolDX: Molecular Diagnostic Tests (MDT) — CGS

Clinical Laboratory · LCD-L36021

Government source· CMS / MACverify ↗
High

Full analysis available with a CLV subscription.

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LCD L38331: MolDX: Blood Product Molecular Antigen Typing — Noridian

Infectious Disease / Microbiology · LCD-L38331

Government source· CMS / MACverify ↗
High

Full analysis available with a CLV subscription.

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LCD L38333: MolDX: Blood Product Molecular Antigen Typing — Noridian

Infectious Disease / Microbiology · LCD-L38333

Government source· CMS / MACverify ↗
High

Full analysis available with a CLV subscription.

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LCD L38649: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer — Noridian

Oncology · LCD-L38649

Government source· CMS / MACverify ↗
High

Full analysis available with a CLV subscription.

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LCD L36256: MolDX: Molecular Diagnostic Tests (MDT) — Noridian

Clinical Laboratory · LCD-L36256

Government source· CMS / MACverify ↗
High

Full analysis available with a CLV subscription.

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LCD L38684: MolDX: Prognostic and Predictive Molecular Classifiers for Bladder Cancer — WPS

Urology · LCD-L38684

Government source· CMS / MACverify ↗
High

Full analysis available with a CLV subscription.

View alert

Audit documentation

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