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See a sample rate comparisonCPT 81224 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.
Cystic Fibrosis Genetic Test, A Lab Analysis Of Genetic Material That Can Indicate Cystic Fibrosis. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Molecular Pathology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory 91 - Repeat Lab Test 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81224 |
| Medicaid Fee Schedule | View Medicaid rates for 81224 |
National average reimbursement for CPT 81224 by major payers:
$128.91
$103.36
$150.34
$266.86
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CPT 81224
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$371.25Published rateMaricopa County Special Health Care District, Valleywise Health
$202.50Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$124.44Published rateChristopher Raio
St Joseph Hospital
$101.25Published rateBrittany Ptachick
Hroa 401k Plan
$70.88Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81224 vs. Other Molecular Pathology Procedures Codes
The CPT 81224 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 81224 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 |
|---|---|---|
| 81220-CPT | Moderate | Cystic Fibrosis Genetic Test, A Lab Analysis Of Genetic Material That Can Indicate Cystic Fibrosis. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81222-CPT | Moderate | Cystic Fibrosis Genetic Test, A Lab Analysis Of Genetic Material That Can Indicate Cystic Fibrosis. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81223-CPT | Moderate | Cystic Fibrosis Genetic Test, A Lab Analysis Of Genetic Material That Can Indicate Cystic Fibrosis. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81224-CPT | Low | Cystic Fibrosis Genetic Test, A Lab Analysis Of Genetic Material That Can Indicate Cystic Fibrosis. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81224. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81224 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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