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See a sample rate comparisonCPT 81193 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.
Mpl (Mpl Proto-Oncogene Throm, Mpl (Mpl Proto-Oncogene Thrombopoietin Receptor) (Eg Myeloproliferative Disorder) Gene Analysis Common Variants (Eg W515a W515k W515l W515r)
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Molecular Pathology Procedures |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None Q6 - Service furnished by a locum tenens physician |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81193 |
| Medicaid Fee Schedule | View Medicaid rates for 81193 |
National average reimbursement for CPT 81193 by major payers:
$192.28
$128.54
$198.98
$309.68
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CPT 81193
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$456.08Published rateChristopher Raio
St Francis Hospital
$273.65Published rateChristopher Raio
Mercy Medical Center
$207.10Published rateCatherine Lee
Columbus Arthritis Center
$124.39Published 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
$72.55Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81193 vs. Other Molecular Pathology Procedures Codes
The CPT 81193 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 81193 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 |
|---|---|---|
| 81191-CPT | Low | Ighbcl2 (T(1418)) (Eg Foll, Ighbcl2 (T(1418)) (Eg Follicular Lymphoma) Translocation Analysis Major Breakpoint Region (Mbr)And Minor Cluster Region (Mcr) Breakpoints Quali Tative Or Quantitative |
| 81192-CPT | Low | Jak2 (Janus Kinase 2) (Eg Mye, Jak2 (Janus Kinase 2) (Eg Myeloproliferative Disorder) Targeted Sequence Analysis (Eg Exons 12 And13) |
| 81193-CPT | Low | Mpl (Mpl Proto-Oncogene Throm, Mpl (Mpl Proto-Oncogene Thrombopoietin Receptor) (Eg Myeloproliferative Disorder) Gene Analysis Common Variants (Eg W515a W515k W515l W515r) |
| 81194-CPT | Moderate | Ntrk (Neurotrophic-Tropomyosin Receptr Tyrosine..., Ntrk (Neurotrophic-Tropomyosin Receptor Tyrosine Kinase 1 2 And 3) (Eg Solid Tumors) Translocation Analysis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81193. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81193 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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