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See a sample rate comparisonHealthcare 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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Molecular Pathology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory 91 - Repeat Lab Test 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81105 |
| Medicaid Fee Schedule | View Medicaid rates for 81105 |
National average reimbursement for CPT 81105 by major payers:

$123.61

$83.60

$121.74

$190.36
Choose a payer to see a sample of rates for CPT 81105.
Merrimack Valley Pediatric Associates, Inc.
Good Samaritan Hosptial Medical Center
Baycare Home Care Inc
Good Samaritan Hosptial Medical Center
E And A Medical On The Go Healthcare Of South Florida LLC
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 81105 vs. Other Molecular Pathology Procedures Codes
The CPT 81105 code is part of the Pathology and Laboratory Procedures services used for Molecular Pathology Procedures. 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 81105 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 |
|---|---|---|
| 81105-CPT | Low | Human Platelet Antigen 1 Genot, Human Platelet Antigen 1 Genotyping (Hpa-1) Itgb3(Integrin Beta 3 [Platelet Glycoprotein Iiia] A Ntigen Cd61 [Gpiiia]) (Eg Neonatal Alloimmune Thrombocytopenia [Nait] Post-Transfusion Purpura) Gene Analysis Common Variant Hpa-1ab (L33p) Pharyngogastrostomy Or Esophagogastrostomy (Ie Th |
| 81106-CPT | Low | Human Platelet Antigen 2 Genot, Human Platelet Antigen 2 Genotyping (Hpa-2) Gp1ba(Glycoprotein Ib [Platelet] Alpha Polypeptide [G Piba]) (Eg Neonatal Alloimmune Thrombocytopenia [Nait] Post-Transfusion Purpura) Gene Analysis Common Variant Hpa-2ab (T145m) Pharyngogastrostomy Or Esophagogastrostomy (Ie Th |
| 81107-CPT | Low | Human Platelet Antigen 3 Genot, Human Platelet Antigen 3 Genotyping (Hpa-3) Itga2b (Integrin Alpha 2b [Platelet Glycoprotein Iib Of Iibiiia Complex] Antigen Cd41 [Gpiib]) (Eg Neonatal Alloimmune Thrombocytopenia [Nait] Post-Transfusion Purpura) Gene Analysis Common Varianthpa-3ab (I843s) |
| 81108-CPT | Low | Human Platelet Antigen 4 Genot, Human Platelet Antigen 4 Genotyping (Hpa-4) Itgb3(Integrin Beta 3 [Platelet Glycoprotein Iiia] A Ntigen Cd61 [Gpiiia]) (Eg Neonatal Alloimmune Thrombocytopenia [Nait] Post-Transfusion Purpura) Gene Analysis Common Variant Hpa-4ab (R143q) Hpa-3ab (I843s) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81105. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81105 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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