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See a sample rate comparisonCPT 81248 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 Anemia, A Lab Analysis Of Genetic Material That Can Indicate Hemolytic Anemia A Condition In Which The Body Destroys Red Blood Cells. 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 |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 81248 |
| Medicaid Fee Schedule | View Medicaid rates for 81248 |
National average reimbursement for CPT 81248 by major payers:
$282.37
$224.09
$344.27
$535.18
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CPT 81248
5 of 25 sample ratesHigher to lower in this preview
Tiziana Califano
Atlantic Health System Inc
$501.66Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$375.25Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$276.72Published rateAnn Steck
Toledo Hospital
$202.26Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$131.33Published rate
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See a sample payer proposalCPT 81248 vs. Other Molecular Pathology Procedures Codes
The CPT 81248 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 81248 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 |
|---|---|---|
| 81246-CPT | Low | Genetic Test For Leukemia, A Lab Analysis Of Genetic Material That Can Indicate Acute Myeloid Leukemia. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81247-CPT | Low | Genetic Test For Anemia, A Lab Analysis Of Genetic Material That Can Indicate Hemolytic Anemia A Condition In Which The Body Destroys Red Blood Cells. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81248-CPT | Moderate | Genetic Test For Anemia, A Lab Analysis Of Genetic Material That Can Indicate Hemolytic Anemia A Condition In Which The Body Destroys Red Blood Cells. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81249-CPT | Moderate | Genetic Test For Anemia, A Lab Analysis Of Genetic Material That Can Indicate Hemolytic Anemia A Condition In Which The Body Destroys Red Blood Cells. 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 81248. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81248 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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