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See a sample rate comparisonCPT 81342 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 Blood Cancer, A Lab Analysis Of Genetic Material That Can Indicate Leukemia Or Lymphoma. 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 22 - On Campus Outpatient Hospital |
| Common Modifiers | None GZ - Item or Service Expected to Be Denied as Not Reasonable and Necessary XE - Separate encounter |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81342 |
| Medicaid Fee Schedule | View Medicaid rates for 81342 |
National average reimbursement for CPT 81342 by major payers:
$167.64
$144.33
$203.85
$313.67
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CPT 81342
5 of 25 sample ratesHigher to lower in this preview
Overlook Hospital
Atlantic Health System Inc
$299.29Published rateJennifer Cox
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$120.90Published rateAldo Rosales
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$102.76Published rateChantal Bryant
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$102.76Published rateHeetal Patel
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$102.76Published rate
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See a sample payer proposalCPT 81342 vs. Other Molecular Pathology Procedures Codes
The CPT 81342 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 81342 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 |
|---|---|---|
| 81341-CPT | Low | Trb Gene Rearrange Dirprobe, Trb T Cell Antigen Receptor Beta Eg Leukemia And Lymphoma Gene Rearrangement Analysis To Detect Abnormal Clonal Population S Using Direct Probe Methodology Eg Southern Blot |
| 81342-CPT | Low | Genetic Test For Blood Cancer, A Lab Analysis Of Genetic Material That Can Indicate Leukemia Or Lymphoma. Types Of Analysis Include Gene Variants Full Sequence Analysis Or Breakpoints. |
| 81343-CPT | Low | Genetic Test For Sca, A Lab Analysis Of Genetic Material That Can Indicate Sca (Spinocerebellar Ataxia) A Disorder Characterized By Progressive Incoordination Of Gait And Is Often Associated With Poor Coordination Of Hands Speech And Eye Movements. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81342. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81342 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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