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See a sample rate comparisonCPT 81210 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.
Braf (B-Raf Proto-Oncogene Se, Braf (B-Raf Proto-Oncogene Serinethreonine Kinase) (Eg Colon Cancer Melanoma) Gene Analysis V600 Variant(S)
| 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 GZ - Item or Service Expected to Be Denied as Not Reasonable and Necessary |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81210 |
| Medicaid Fee Schedule | View Medicaid rates for 81210 |
National average reimbursement for CPT 81210 by major payers:
$138.38
$108.54
$162.20
$275.38
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CPT 81210
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$385.88Published rateChristopher Raio
St Joseph Hospital
$231.53Published rateMichael Shuler
Athens Orthopedic Clinic, P.A.
$105.24Published rateCharleston Radiologists PA
Charleston Radiologists, P.A.
$89.63Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$71.69Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81210 vs. Other Molecular Pathology Procedures Codes
The CPT 81210 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 81210 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 |
|---|---|---|
| 81206-CPT | Low | Bcrabl1 (T(922)) (Eg Chroni, Bcrabl1 (T(922)) (Eg Chronic Myelogenous Leukemia) Translocation Analysis Major Breakpoint Qualitative Or Quantitative |
| 81207-CPT | Low | Bcrabl1 (T(922)) (Eg Chroni, Bcrabl1 (T(922)) (Eg Chronic Myelogenous Leukemia) Translocation Analysis Minor Breakpoint Qualitative Or Quantitative |
| 81209-CPT | Low | Blm (Bloom Syndro Recq Helicas-Like) (Eg Bloom Syndro) Gene Ana, Blm (Bloom Syndrome Recq Helicase-Like) (Eg Bloom Syndrome) Gene Ana |
| 81210-CPT | Low | Braf (B-Raf Proto-Oncogene Se, Braf (B-Raf Proto-Oncogene Serinethreonine Kinase) (Eg Colon Cancer Melanoma) Gene Analysis V600 Variant(S) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81210. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81210 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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