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See a sample rate comparisonCPT 0138U 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.
Brca1 Brca2 Mrna Seq Alys, Brca1 (Brca1 Dna Repair Associated) Brca2 (Brca2 Dna Repair Associated) (Eg Hereditary Breast And Ovarian Cancer) Mrna Sequence Analysis (List Separately In A Ition To Code For Primary Procedure) (Use 0138u In Conjunction With 81162)
| Key Fact | Detail |
|---|---|
| Service Type | Proprietary Laboratory Analyses |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 0138U |
| Medicaid Fee Schedule | View Medicaid rates for 0138U |
National average reimbursement for CPT 0138U by major payers:
$484.08
$468.50
$N/A
$684.12
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CPT 0138U
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$1,030.33Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$556.38Published rateChristopher Raio
St Francis Hospital
$467.86Published rateCatherine Lee
Columbus Arthritis Center
$281.00Published 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
$163.91Published rate
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See a sample payer proposalCPT 0138U vs. Other Proprietary Laboratory Analyses Codes
The CPT 0138U 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 0138U 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 |
|---|---|---|
| 0138U-CPT | Moderate | Brca1 Brca2 Mrna Seq Alys, Brca1 (Brca1 Dna Repair Associated) Brca2 (Brca2 Dna Repair Associated) (Eg Hereditary Breast And Ovarian Cancer) Mrna Sequence Analysis (List Separately In A Ition To Code For Primary Procedure) (Use 0138u In Conjunction With 81162) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0138U. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0138U 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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