# CPT 81243: FMR1 gene analysis (Fragile X)

Medicare CPT 81243 pays $57.04 under the 2026 Q4 Medicare Clinical Laboratory Fee Schedule, the same national rate in every state.

Web page: https://www.med-reveal.com/rates/81243-cpt-fee-schedule
Section: Laboratory and Pathology
Billed by: Clinical Genetics (M.D.)

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $57.04 |
| National facility | $57.04 |
| Release | 2026 Q4 (effective 2026-10-01) |

## Related codes

- 81165: BRCA1 gene, full sequence analysis — https://www.med-reveal.com/rates/81165-cpt-fee-schedule
- 81167: BRCA1/BRCA2 gene, duplication/deletion analysis — https://www.med-reveal.com/rates/81167-cpt-fee-schedule
- 81185: ABCB4 gene analysis — https://www.med-reveal.com/rates/81185-cpt-fee-schedule
- 81220: CFTR gene, common variants (cystic fibrosis) — https://www.med-reveal.com/rates/81220-cpt-fee-schedule
- 81222: CFTR gene, duplication/deletion variants — https://www.med-reveal.com/rates/81222-cpt-fee-schedule
- 81223: CFTR gene, full sequence analysis — https://www.med-reveal.com/rates/81223-cpt-fee-schedule
- 81228: Cytogenomic microarray analysis, constitutional — https://www.med-reveal.com/rates/81228-cpt-fee-schedule
- 81229: Cytogenomic microarray analysis, constitutional, genome-wide — https://www.med-reveal.com/rates/81229-cpt-fee-schedule

Commercial negotiated rates for 81243 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules