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See a sample rate comparisonCPT 81111 Fee Schedule
Last Verified: September 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.
Human Platelet Antigen 9 Genot, Human Platelet Antigen 9 Genotyping (Hpa-9w) Itga2b (Integrin Alpha 2b [Platelet Glycoprotein Iib Of Iibiiia Complex Antigen Cd41] [Gpiib]) (Eg Neonatal Alloimmune Thrombocytopenia [Nait] Post-Transfusion Purpura) Gene Analysis Common Variant Hpa-9ab (V837m)
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Molecular Pathology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 91 - Repeat Lab Test 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81111 |
| Medicaid Fee Schedule | View Medicaid rates for 81111 |
National average reimbursement for CPT 81111 by major payers:
$125.02
$83.60
$121.80
$191.71
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CPT 81111
5 of 25 sample ratesHigher to lower in this preview
Matthew Lilley
Bend Memorial Clinic, PC
$183.33Published rateAaron Askew
Praxis Health, P.C.
$134.44Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$73.33Published rateChristopher Raio
St Francis Hospital
$66.00Published 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
$42.77Published rate
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See a sample payer proposalCPT 81111 vs. Other Molecular Pathology Procedures Codes
The CPT 81111 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 81111 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 |
|---|---|---|
| 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) |
| 81110-CPT | Low | Human Platelet Antigen 6 Genot, Human Platelet Antigen 6 Genotyping (Hpa-6w) Itgb3 (Integrin Beta 3 [Platelet Glycoprotein Iiia Antigen Cd61] [Gpiiia]) (Eg Neonatal Alloimmune Thrombocytopenia [Nait] Post-Transfusion Purpura) Gene Analysis Common Variant Hpa-6ab (R489q) Hpa-3ab (I843s) |
| 81111-CPT | Low | Human Platelet Antigen 9 Genot, Human Platelet Antigen 9 Genotyping (Hpa-9w) Itga2b (Integrin Alpha 2b [Platelet Glycoprotein Iib Of Iibiiia Complex Antigen Cd41] [Gpiib]) (Eg Neonatal Alloimmune Thrombocytopenia [Nait] Post-Transfusion Purpura) Gene Analysis Common Variant Hpa-9ab (V837m) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81111. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81111 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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