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See a sample rate comparisonCPT 0155U 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 Brst Ca Dna Pik3ca Gene, Oncology Breast Cancer Dna Pik3ca Phosphatidylinositol 4 5 Bisphosphate 3 Kinase Catalytic Subunit Alpha Eg Breast Cancer Gene Analysis Ie P C420r P E542k P E545a P E545d G 1635g T Only P E545g P E545k P Q546e P Q546r P H1047l P H1047r P H1047y Utilizing Formalin Fixed Paraffin Embedded Breast Tumor Tissue Reported As Pik3ca Gene Mutation Status
| Key Fact | Detail |
|---|---|
| Service Type | Proprietary Laboratory Analyses |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 0155U |
| Medicaid Fee Schedule | View Medicaid rates for 0155U |
National average reimbursement for CPT 0155U by major payers:
$258.53
$246.71
$724.69
$534.18
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CPT 0155U
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$604.63Published rateChristopher Raio
St Joseph Hospital
$326.50Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$202.66Published rateAnn Steck
Toledo Hospital
$148.13Published 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
$96.19Published rate
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See a sample payer proposalCPT 0155U vs. Other Proprietary Laboratory Analyses Codes
The CPT 0155U 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 0155U 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 |
|---|---|---|
| 0155U-CPT | Moderate | Onc Brst Ca Dna Pik3ca Gene, Oncology Breast Cancer Dna Pik3ca Phosphatidylinositol 4 5 Bisphosphate 3 Kinase Catalytic Subunit Alpha Eg Breast Cancer Gene Analysis Ie P C420r P E542k P E545a P E545d G 1635g T Only P E545g P E545k P Q546e P Q546r P H1047l P H1047r P H1047y Utilizing Formalin Fixed Paraffin Embedded Breast Tumor Tissue Reported As Pik3ca Gene Mutation Status |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0155U. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0155U 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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