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See a sample rate comparisonCPT 81326 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.
Analysis For Genetic Disease, A Lab Analysis Of Genetic Material That Can Indicate Peripheral Neuropathies Such As Charcot-Marie-Tooth. 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 | 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $46.60 national lab fee schedule rate (2026) · View Medicare rates for 81326 |
| Medicaid Fee Schedule | $44.535 median of the 8 states in the free preview · View Medicaid rates for 81326 |
National average reimbursement for CPT 81326 by major payers:
$54.82
$30.44
$51.65
$87.71
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CPT 81326
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See a sample payer proposalCPT 81326 vs. Other Molecular Pathology Procedures Codes
The CPT 81326 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 81326 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 |
| 81324-CPT | Moderate | Analysis For Genetic Disease, A Lab Analysis Of Genetic Material That Can Indicate Peripheral Neuropathies Such As Charcot-Marie-Tooth. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81325-CPT | Moderate | Analysis For Genetic Disease, A Lab Analysis Of Genetic Material That Can Indicate Peripheral Neuropathies Such As Charcot-Marie-Tooth. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81326-CPT | Low | Analysis For Genetic Disease, A Lab Analysis Of Genetic Material That Can Indicate Peripheral Neuropathies Such As Charcot-Marie-Tooth. 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 81326. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81326 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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