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See a sample rate comparisonCPT 81202 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.
Genetic Test For Fap, A Lab Analysis Of Genetic Material That Can Indicate The Likelihood Of Developing Polyps Followed By Colon Cancer. This Is A Condition Called Fap (Familial Adenomatous Polyposis).
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Molecular Pathology Procedures |
| Common Place of Service | 81 - Independent Laboratory 99 - Other POS |
| Common Modifiers | None XU - Unusual Non-Overlapping Service 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 81202 |
| Medicaid Fee Schedule | View Medicaid rates for 81202 |
National average reimbursement for CPT 81202 by major payers:
$250.38
$171.52
$252.37
$429.51
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CPT 81202
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$616.00Published rateChristopher Raio
St Joseph Hospital
$279.72Published rateProgressive Medical Center Sc
Progressive Medical Center, S.C.
$154.00Published rateAaron Askew
The Orthopedic And Neurosurgical Center Of The Cascades
$117.60Published rateDermatology And Skin Cancer Surgery Center, LLC, Orlando Dermatology Center
Dermatology And Skin Cancer Surgery Center LLC
$117.59Published rate
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See a sample payer proposalCPT 81202 vs. Other Molecular Pathology Procedures Codes
The CPT 81202 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 81202 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 |
|---|---|---|
| 81200-CPT | Low | Aspa (Aspartoacylase) (Eg Canavan Diseas) Gene Analy Common Vari, Aspa (Aspartoacylase) (Eg Canavan Disease) Gene Analysis Common Vari |
| 81201-CPT | Moderate | Genetic Test For Fap, A Lab Analysis Of Genetic Material That Can Indicate The Likelihood Of Developing Polyps Followed By Colon Cancer. This Is A Condition Called Fap (Familial Adenomatous Polyposis). |
| 81202-CPT | Moderate | Genetic Test For Fap, A Lab Analysis Of Genetic Material That Can Indicate The Likelihood Of Developing Polyps Followed By Colon Cancer. This Is A Condition Called Fap (Familial Adenomatous Polyposis). |
| 81203-CPT | Moderate | Genetic Test For Fap, A Lab Analysis Of Genetic Material That Can Indicate The Likelihood Of Developing Polyps Followed By Colon Cancer. This Is A Condition Called Fap (Familial Adenomatous Polyposis). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81202. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81202 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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