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See a sample rate comparisonCPT 0130U 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.
Hered Colon Ca Do Mrna Pnl, Hereditary Colon Cancer Disorders (Eg Lynch Syndrome Pten Hamartoma Syndrome Cowden Syndrome Familial Adenomatosis Polyposis) Targeted Mrna Sequence Analysis Panel (Apc Cdh1 Chek2 Mlh1 Msh2 Msh6 Mutyh Pms2 Pten And Tp53) (List Separately In A Ition To Code For Primary Procedure) (Use 0130u In Conjunction With 81435 0101u)
| Key Fact | Detail |
|---|---|
| Service Type | Proprietary Laboratory Analyses |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 0130U |
| Medicaid Fee Schedule | View Medicaid rates for 0130U |
National average reimbursement for CPT 0130U by major payers:
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CPT 0130U
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$1,286.78Published rateChristopher Raio
St Francis Hospital
$772.07Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$584.90Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$431.32Published 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
$204.72Published rate
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See a sample payer proposalCPT 0130U vs. Other Proprietary Laboratory Analyses Codes
The CPT 0130U 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 0130U 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 |
|---|---|---|
| 0130U-CPT | Moderate | Hered Colon Ca Do Mrna Pnl, Hereditary Colon Cancer Disorders (Eg Lynch Syndrome Pten Hamartoma Syndrome Cowden Syndrome Familial Adenomatosis Polyposis) Targeted Mrna Sequence Analysis Panel (Apc Cdh1 Chek2 Mlh1 Msh2 Msh6 Mutyh Pms2 Pten And Tp53) (List Separately In A Ition To Code For Primary Procedure) (Use 0130u In Conjunction With 81435 0101u) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0130U. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0130U 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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