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See a sample rate comparisonCPT 81300 Fee Schedule
Last Verified: October 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 Colon Cancer, A Lab Analysis Of Genetic Material That Can Indicate Risk Of Developing Colon Cancer. 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 | 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $238.00 national lab fee schedule rate (2026) · View Medicare rates for 81300 |
| Medicaid Fee Schedule | $224.025 median of the 8 states in the free preview · View Medicaid rates for 81300 |
National average reimbursement for CPT 81300 by major payers:
$179.61
$125.31
$210.89
$361.54
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CPT 81300
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$523.60Published rateMaricopa County Special Health Care District, Valleywise Health
$285.60Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$128.52Published rateRolando Henriquez
Progressive Medical Center, S.C.
$99.95Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$64.66Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81300 vs. Other Molecular Pathology Procedures Codes
The CPT 81300 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 81300 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 |
|---|---|---|
| 81292-CPT | Moderate | Mlh1 (Mutl Homolog 1 Colon Ca, Mlh1 (Mutl Homolog 1 Colon Cancer Nonpolyposis Type 2) (Eg Hereditary Non-Polyposis Colorectal Cancer Lynch Syndrome) Gene Analysis Full Sequenceanalysis |
| 81298-CPT | Moderate | Genetic Test For Colon Cancer, A Lab Analysis Of Genetic Material That Can Indicate Risk Of Developing Colon Cancer. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81299-CPT | Moderate | Genetic Test For Colon Cancer, A Lab Analysis Of Genetic Material That Can Indicate Risk Of Developing Colon Cancer. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81300-CPT | Low | Genetic Test For Colon Cancer, A Lab Analysis Of Genetic Material That Can Indicate Risk Of Developing Colon 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 81300. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81300 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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