CPT 81229 Fee Schedule
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.
| 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 • 26 - Professional component |
| Complexity Level | Moderate |
National average reimbursement for CPT 81229 by major payers:
$914.06
$711.16
$1,016.26
$1,737.23
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 81229 | ||||||
United | 81229 | $5374.04 | 1972950665 - WENDY CONLON | 954377219 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81229 | $1044.00 | 1902469653 - CLHG-DEQUINCY, LLC | 364911029 - (LA) CLHGDEQUINCY LLC | LA | Critical Access Hospital (282NC0060X) |
United | 81229 | $1218.00 | 1780818302 - NIKKI MADSON | 943281666 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81229 | $5729.00 | 1053701177 - MIYA FRICK | 943281662 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81229 | $1548.14 | 1831403211 - HIND AL SAIF | 541581185 - MCV ASSOCIATED PHYSICIANS | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $2984.67 | 1598141475 - MIGUEL DEL CAMPO CASANELLES | 951691313 - RADY CHILDRENS HOSPITAL-SAN DIEGO | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $4729.08 | 1689657579 - DEBORAH KRAKOW | 954373070 | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $487.20 | 1942683552 - CAITLIN HALE | 113650756 - (OR) MARC E. LEWIS, MD, LLC | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81229 | $4729.08 | 1609226992 - DANIELLA KAMARA | 954377219 | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $5729.00 | 1588744908 - ALEKSANDAR RAJKOVIC | 943281657 | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $487.20 | 1356524235 - HEATHER WETZEL | 842664261 - (CA) DNAFORWARD PC | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81229 | $1484.80 | 1841794567 - LAURA WILSON | 61330992 - NORTHEAST MEDICAL GROUP INC | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $1881.09 | 1073054722 - HELIO COSTA | 770465765 | CA | Clinical Molecular Genetics Physician (207SG0203X) |
United | 81229 | $513.88 | 1396014866 - KATHRYN SINGH | 271504911 - (CA) MEMORIALCARE MEDICAL FOUNDATION | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81229 | $696.00 | 1669811022 - ANNA VILLA | 341369963 - (OH) BLANCHARD VALLEY REGIONAL HEALTH CENTER | CA | Genetic Counselor (M.S.) (170300000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 81229 vs. Other Molecular Pathology Procedures Codes
The CPT 81229 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 81229 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 |
|---|---|---|
| 81201-CPT | Moderate | Apc (Adenomatous Polyposis Coli) (Eg, Familial Adenomatosis Polyposis (Fap), Attenuated Fap) Gene Analysis; Full Gene Sequence |
| 81224-CPT | Low | Cftr (Cystic Fibrosis Transmembrane Conductance Regulator) (Eg, Cystic Fibrosis) Gene Analysis; Intron 8 Poly-T Analysis (Eg, Male Infertility) |
| 81226-CPT | Moderate | Cyp2d6 (Cytochrome P450, Family 2, Subfamily D, Polypeptide 6) (Eg, Drug Metabolism), Gene Analysis, Common Variants (Eg, *2, *3, *4, *5, *6, *9, *10, *17, *19, *29, *35, *41, *1xn, *2xn, *4xn) |
| 81229-CPT | Moderate | Cytogenomic (Genome-Wide) Analysis For Constitut- Ional Chromosomal Abnormalities; Interrogation Of Genomic Regions For Copy Number And Single Nucleotide Polymorphism (Snp) Variants Compara- Tive Genomic Hybridization (Cgh) Microarray Analysis (Desc Rvsd 1/1/22) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81229. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81229 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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