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See a sample rate comparisonCPT 0016M Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Onc Bladder Mrna 219 Gen Alg, Oncology Bladder Mrna Microarray Gene Expression Profiling Of 219 Genes Utilizing Formalin Fixed Paraffin Embedded Tissue Algorithm Reported As Molecular Subtype Luminal Luminal Infiltrated Basal Basal Claudin Low Neuroendocrine Like
| Key Fact | Detail |
|---|---|
| Service Type | Multianalyte Assay |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 0016M |
| Medicaid Fee Schedule | View Medicaid rates for 0016M |
National average reimbursement for CPT 0016M by major payers:
$3,114.35
$1,954.19
$N/A
$5,459.67
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CPT 0016M
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$7,677.19Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$3,489.63Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$2,573.38Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$1,744.82Published 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
$1,221.36Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 0016M vs. Other Multianalyte Assay Codes
The CPT 0016M 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 0016M 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 |
|---|---|---|
| 0016M-CPT | High | Onc Bladder Mrna 219 Gen Alg, Oncology Bladder Mrna Microarray Gene Expression Profiling Of 219 Genes Utilizing Formalin Fixed Paraffin Embedded Tissue Algorithm Reported As Molecular Subtype Luminal Luminal Infiltrated Basal Basal Claudin Low Neuroendocrine Like |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0016M. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0016M 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.
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