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 | Genetic Analysis Procedures Tier 1 Molecular Pathology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 81229 |
National average reimbursement for CPT 81229 by major payers:
$914.06
$711.16
$1,016.26
$1,675.18
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 81229 | $3925.66 | 1184736225 - STACY GRAY | 274803222 - CITY OF HOPE MEDICAL FOUNDATION | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $1160.00 | 1609275585 - CHCA PEARLAND, L.P., HCA HOUSTON HEALTHCARE PEARLAND | 50631189 | TX | General Acute Care Hospital (282N00000X) |
United | 81229 | $5374.04 | 1235165796 - WAYNE GRODY | 954377219 | CA | Molecular Genetic Pathology (Pathology) Physician (207ZP0007X) |
United | 81229 | $4729.08 | 1689657579 - DEBORAH KRAKOW | 954373070 | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $1548.14 | 1831403211 - HIND AL SAIF | 541581185 - MCV ASSOCIATED PHYSICIANS | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $1218.00 | 1780818302 - NIKKI MADSON | 943281666 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81229 | $1160.00 | 1215121132 - OPHIR KLEIN | 943191703 | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $1881.09 | 1073054722 - HELIO COSTA | 770465765 | CA | Clinical Molecular Genetics Physician (207SG0203X) |
United | 81229 | $6365.62 | 1346239159 - JULIANNE WOJCIAK | 943281660 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81229 | $1160.00 | 1700885076 - TH HEALTHCARE, LTD, NACOGDOCHES MEDICAL CENTER | 760354630 | TX | General Acute Care Hospital (282N00000X) |
United | 81229 | $1392.00 | 1689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL | 752313255 | TX | General Acute Care Hospital (282N00000X) |
United | 81229 | $4045.62 | 1487920724 - KRISTEN WIGBY | 237064656 - HEALING THE SOUL | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $6365.62 | 1972034841 - DAVID BLAIR | 943281666 | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81229 | $1881.09 | 1801343215 - SWAROOP ARADHYA | 770465765 | CA | Ph.D. Medical Genetics (170100000X) |
United | 81229 | $1881.09 | 1740526920 - JENICE SICAN | 260089066 | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 81229 vs. Other Tier 1 Molecular Pathology Procedures Codes
The CPT 81229 code is part of the Genetic Analysis Procedures services used for Tier 1 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 | 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). |
| 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. |
| 81226-CPT | Moderate | Cyp2d6 Gene Com Variants, 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 | Cytog Alys Chrml Abnr Snpcgh, Cytogenomic Genome Wide Analysis For Constitutional Chromosomal Abnormalities Interrogation Of Genomic Regions For Copy Number And Single Nucleotide Polymorphism Snp Variants Comparative Genomic Hybridization Cgh Microarray Analysis |
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 81229) and we'll show you how you compare in 15 minutes or less.