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See a sample rate comparisonCPT 81346 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 Drug Therapy, A Lab Test That Evaluates How Well A Drug Is Metabolized By The Body. This Helps To Identify The Most Effective Drug Therapy And The Likelihood Of Developing Severe Side Effects.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Molecular Pathology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81346 |
| Medicaid Fee Schedule | View Medicaid rates for 81346 |
National average reimbursement for CPT 81346 by major payers:
$159.53
$107.14
$160.03
$261.11
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CPT 81346
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$384.58Published rateAaron Askew
Praxis Health, P.C.
$192.29Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$128.91Published rateChristopher Raio
St Francis Hospital
$94.40Published rateBaptist Health Care, Inc., Baptist Home Healt Care And Medical Equipment
Baptist Health Care Inc
$73.41Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81346 vs. Other Molecular Pathology Procedures Codes
The CPT 81346 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 81346 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 |
|---|---|---|
| 81345-CPT | Low | Tert Gene Targeted Seq Alys, Tert Telomerase Reverse Transcriptase Eg Thyroid Carcinoma Glioblastoma Multiforme Gene Analysis Targeted Sequence Analysis Eg Promoter Region |
| 81346-CPT | Low | Genetic Test For Drug Therapy, A Lab Test That Evaluates How Well A Drug Is Metabolized By The Body. This Helps To Identify The Most Effective Drug Therapy And The Likelihood Of Developing Severe Side Effects. |
| 81347-CPT | Low | Sf3b1 Gene Common Variants, Sf3b1 Splicing Factor 3b Subunit B1 Eg Myelodysplastic Syndrome Acute Myeloid Leukemia Gene Analysis Common Variants Eg A672t E622d L833f R625c R625l |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81346. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81346 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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