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See a sample rate comparisonCPT 81170 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.
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.
| 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 90 - Reference Laboratory 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 81170 |
| Medicaid Fee Schedule | View Medicaid rates for 81170 |
National average reimbursement for CPT 81170 by major payers:
$266.47
$191.90
$292.29
$440.06
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CPT 81170
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$660.00Published rateChristopher Raio
St Francis Hospital
$356.40Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$300.00Published rateChristopher Raio
St Francis Hospital
$180.00Published rateAaron Askew
The Orthopedic And Neurosurgical Center Of The Cascades
$126.00Published rate
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See a sample payer proposalCPT 81170 vs. Other Molecular Pathology Procedures Codes
The CPT 81170 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 81170 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) |
| 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. |
| 81171-CPT | Low | Aff2 Gen Aly Detc Abnl Allel, Aff2 Alf Transcription Elongation Factor 2 Fmr2 Eg Fragile X Intellectual Disability 2 Fraxe Gene Analysis Evaluation To Detect Abnormal Eg Expanded Alleles |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81170. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81170 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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