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See a sample rate comparisonCPT 81318 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.
Pms2 Known Familial Variants, Pms2 Postmeiotic Segregation Increased 2 S Cerevisiae Eg Hereditary Non Polyposis Colorectal Cancer Lynch Syndrome Gene Analysis Known Familial Variants
| 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 | Moderate |
| Medicare Fee Schedule | $331.00 national lab fee schedule rate (2026) · View Medicare rates for 81318 |
| Medicaid Fee Schedule | $326.865 median of the 8 states in the free preview · View Medicaid rates for 81318 |
National average reimbursement for CPT 81318 by major payers:
$240.73
$163.43
$280.45
$491.91
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CPT 81318
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$728.20Published rateChristopher Raio
St Joseph Hospital
$393.23Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$198.60Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$136.88Published rateDermatology And Skin Cancer Surgery Center, LLC, Orlando Dermatology Center
Dermatology And Skin Cancer Surgery Center LLC
$77.41Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81318 vs. Other Molecular Pathology Procedures Codes
The CPT 81318 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 81318 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 |
| 81317-CPT | Moderate | Pms2 Gene Full Seq Analysis, Pms2 Postmeiotic Segregation Increased 2 S Cerevisiae Eg Hereditary Non Polyposis Colorectal Cancer Lynch Syndrome Gene Analysis Full Sequence Analysis |
| 81318-CPT | Moderate | Pms2 Known Familial Variants, Pms2 Postmeiotic Segregation Increased 2 S Cerevisiae Eg Hereditary Non Polyposis Colorectal Cancer Lynch Syndrome Gene Analysis Known Familial Variants |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81318. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81318 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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