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See a sample rate comparisonCPT 81301 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.
Microsatellite Instability, Microsatellite Instability Analysis Eg Hereditary Non Polyposis Colorectal Cancer Lynch Syndrome Of Markers For Mismatch Repair Deficiency Eg Bat25 Bat26 Includes Comparison Of Neoplastic And Normal Tissue If Performed
| 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 | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $348.56 national lab fee schedule rate (2026) · View Medicare rates for 81301 |
| Medicaid Fee Schedule | $338.685 median of the 8 states in the free preview · View Medicaid rates for 81301 |
National average reimbursement for CPT 81301 by major payers:
$272.87
$226.25
$334.38
$524.16
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CPT 81301
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
Good Samaritan Hosptial Medical Center
$460.10Published rateChristopher Raio
Mercy Medical Center
$396.80Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$292.91Published rateChristopher Raio
St Joseph Hospital
$209.14Published rateRenal Consultants Medical Group
$146.39Published rate
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See a sample payer proposalCPT 81301 vs. Other Molecular Pathology Procedures Codes
The CPT 81301 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 81301 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 |
| 81294-CPT | Low | Mlh1 Gene Dup Delete Variant, Mlh1 Mutl Homolog 1 Colon Cancer Nonpolyposis Type 2 Eg Hereditary Non Polyposis Colorectal Cancer Lynch Syndrome Gene Analysis Duplication Deletion Variants |
| 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. |
| 81301-CPT | Moderate | Microsatellite Instability, Microsatellite Instability Analysis Eg Hereditary Non Polyposis Colorectal Cancer Lynch Syndrome Of Markers For Mismatch Repair Deficiency Eg Bat25 Bat26 Includes Comparison Of Neoplastic And Normal Tissue If Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81301. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81301 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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