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See a sample rate comparisonCPT 81273 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.
Pathology Panel/Obstetric, Kit (V-Kit Hardy-Zuckerman 4 Feline Sarcoma Viral Oncogene Homolog) (Eg Gastrointestinal Stromal Tumor [Gist] Acute Myeloid Leukemia Melanoma) Gene Analysis Targeted Sequence Analysis (Eg Exons 8 11 13 17 18)
| 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 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81273 |
| Medicaid Fee Schedule | View Medicaid rates for 81273 |
National average reimbursement for CPT 81273 by major payers:
$114.20
$76.57
$119.78
$194.60
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CPT 81273
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$274.71Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$125.61Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$92.73Published rateMolly Mcintosh
Baycare Medical Group Inc
$52.81Published 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
$43.70Published rate
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See a sample payer proposalCPT 81273 vs. Other Molecular Pathology Procedures Codes
The CPT 81273 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 81273 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 |
|---|---|---|
| 81272-CPT | Moderate | Kit Gene Targeted Seq Analys, Kit V Kit Hardy Zuckerman 4 Feline Sarcoma Viral Oncogene Homolog Eg Gastrointestinal Stromal Tumor Gist Acute Myeloid Leukemia Melanoma Gene Analysis Targeted Sequence Analysis Eg Exons 8 11 13 17 18 |
| 81273-CPT | Low | Pathology Panel/Obstetric, Kit (V-Kit Hardy-Zuckerman 4 Feline Sarcoma Viral Oncogene Homolog) (Eg Gastrointestinal Stromal Tumor [Gist] Acute Myeloid Leukemia Melanoma) Gene Analysis Targeted Sequence Analysis (Eg Exons 8 11 13 17 18) |
| 81274-CPT | Moderate | Huntington Disease Test, A Lab Analysis Of Genetic Material That Can Indicate Huntington Disease Which Causes The Breakdown Of Nerve Cells In The Brain. |
| 81275-CPT | Low | Genetic Test For Cancer, A Lab Analysis Of Genetic Material That Can Indicate Cancer. 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 81273. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81273 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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