Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 81120 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.
Idh1 (Isocitrate Dehydrogenase, Idh1 (Isocitrate Dehydrogenase 1 [Nadp] Soluble)(Eg Glioma) Common Variants (Eg R132h R132c) Ransfusion 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 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81120 |
| Medicaid Fee Schedule | View Medicaid rates for 81120 |
National average reimbursement for CPT 81120 by major payers:
$181.87
$118.54
$184.06
$290.55
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 81120.
CPT 81120
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
Mercy Medical Center
$270.55Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$193.25Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$142.50Published rateNevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
$81.17Published 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
$67.63Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 81120 vs. Other Molecular Pathology Procedures Codes
The CPT 81120 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 81120 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 |
|---|---|---|
| 81120-CPT | Low | Idh1 (Isocitrate Dehydrogenase, Idh1 (Isocitrate Dehydrogenase 1 [Nadp] Soluble)(Eg Glioma) Common Variants (Eg R132h R132c) Ransfusion Purpura) Gene Analysis Common Variant Hpa-9ab (V837m) |
| 81121-CPT | Moderate | Idh2 (Isocitrate Dehydrogenase, Idh2 (Isocitrate Dehydrogenase 2 [Nadp] Mitochondrial) (Eg Glioma) Common Variants (Eg R140w R172m) Ransfusion Purpura) Gene Analysis Common Variant Hpa-9ab (V837m) |
| 81161-CPT | Moderate | Test For Muscular Dystrophy, This Test Checks For Mutations Of The Dmd Gene Which Affects Production Of The Protein Dystrophin. When Mutations Are Present This Can Cause Duchenne/Becker Muscular Dystrophy A Progressive Condition Affecting Muscles. |
| 81170-CPT | Moderate | Abl1(Abl Proto-Oncogene 1 Non Recptor Tyrosine Kinase), Abl1(Abl Proto-Oncogene 1 Non Receptor Tyrosine Kinase) (Eg. Aquired Imatinib Tyrosine Kinase Inhibitor Resistance) Gene Analysis Variants In The Kinase Domain. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81120 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 81120) and we'll show you how you compare in 15 minutes or less.