Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 0011M Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Onc Prst8 Ca Mrna 12 Gen Alg, Oncology Prostate Cancer Mrna Expression Assay Of 12 Genes 10 Content And 2 Housekeeping Rt Pcr Test Utilizing Blood Plasma And Urine Algorithms To Predict High Grade Prostate Cancer Risk
| Key Fact | Detail |
|---|---|
| Service Type | Multianalyte Assay |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 0011M |
| Medicaid Fee Schedule | View Medicaid rates for 0011M |
National average reimbursement for CPT 0011M by major payers:
$N/A
$N/A
$N/A
$N/A
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 0011M.
CPT 0011M
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$1,672.00Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$760.00Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$560.45Published rateMark Vital
Hea Clinic, P.A.
$319.20Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$266.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 0011M vs. Other Multianalyte Assay Codes
The CPT 0011M code is part of the Multianalyte Assay services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 0011M code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 0011M-CPT | Moderate | Onc Prst8 Ca Mrna 12 Gen Alg, Oncology Prostate Cancer Mrna Expression Assay Of 12 Genes 10 Content And 2 Housekeeping Rt Pcr Test Utilizing Blood Plasma And Urine Algorithms To Predict High Grade Prostate Cancer Risk |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0011M. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0011M fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 0011M) and we'll show you how you compare in 15 minutes or less.