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See a sample rate comparisonCPT 0045U 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 Brst Dux Carc Is Mrna 12 Genes Alg Rsk Scor, Oncology (Breast Ductal Carcinoma In Situ) Mrna Gene Expression Profiling By Real-Time Rt-Pcr Of 12 Genes (7 Content And 5 Housekeeping) Utilizing Formalin-Fixed Paraffin-Embedded Tissue Algorithm Reported As Recurrence Score
| Key Fact | Detail |
|---|---|
| Service Type | Proprietary Laboratory Analyses |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 0045U |
| Medicaid Fee Schedule | View Medicaid rates for 0045U |
National average reimbursement for CPT 0045U by major payers:
$3,016.91
$3,476.69
$7,501.28
$5,625.55
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CPT 0045U
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$8,520.60Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$5,112.36Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$2,856.11Published rateKevin Schlessel
Columbus Arthritis Center
$2,323.80Published rateBaptist Health Care, Inc., Baptist Home Healt Care And Medical Equipment
Baptist Health Care Inc
$1,626.66Published rate
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See a sample payer proposalCPT 0045U vs. Other Proprietary Laboratory Analyses Codes
The CPT 0045U code is part of the Proprietary Laboratory Analyses 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 0045U 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 |
|---|---|---|
| 0045U-CPT | High | Onc Brst Dux Carc Is Mrna 12 Genes Alg Rsk Scor, Oncology (Breast Ductal Carcinoma In Situ) Mrna Gene Expression Profiling By Real-Time Rt-Pcr Of 12 Genes (7 Content And 5 Housekeeping) Utilizing Formalin-Fixed Paraffin-Embedded Tissue Algorithm Reported As Recurrence Score |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0045U. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0045U 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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