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See a sample rate comparisonCPT 81195 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Cytog Gen-Wide Alys Hem Mal Strux Vrnt&Cnv Ogm, Cytogenomic (Genome-Wide) Analysis Hematologic Malignancy Structural Variants And Copy Number Variants Optical Genome
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Molecular Pathology Procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 81195 |
| Medicaid Fee Schedule | View Medicaid rates for 81195 |
National average reimbursement for CPT 81195 by major payers:
$1,351.04
$1,134.24
$2,419.09
$1,664.16
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CPT 81195
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$3,078.09Published rateChi Memorial Hospital
Chi Memorial Hospital - Georgia
$758.11Published rateNorthside Hospital, Inc., Northside Hospital Duluth
$707.58Published rateThe Hospital Authority Of Miller County, Miller County Hospital - Pro Fees
The Hospital Authority Of Miller County
$606.48Published rateMichael Guillette
Aztec Urgent Care LLC
$530.67Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81195 vs. Other Molecular Pathology Procedures Codes
The CPT 81195 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 81195 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 |
|---|---|---|
| 81195-CPT | High | Cytog Gen-Wide Alys Hem Mal Strux Vrnt&Cnv Ogm, Cytogenomic (Genome-Wide) Analysis Hematologic Malignancy Structural Variants And Copy Number Variants Optical Genome |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81195. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81195 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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