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See a sample rate comparisonCPT 81350 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.
Ugt1a1 Gene Common Variants, Ugt1a1 Udp Glucuronosyltransferase 1 Family Polypeptide A1 Eg Drug Metabolism Hereditary Unconjugated Hyperbilirubinemia Gilbert Syndrome Gene Analysis Common Variants Eg 28 36 37
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Molecular Pathology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81350 |
| Medicaid Fee Schedule | View Medicaid rates for 81350 |
National average reimbursement for CPT 81350 by major payers:
$174.87
$143.31
$205.05
$360.82
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CPT 81350
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$514.80Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$234.00Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$172.55Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$126.36Published rateBaptist Health Care, Inc., Baptist Home Healt Care And Medical Equipment
Baptist Health Care Inc
$98.27Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81350 vs. Other Molecular Pathology Procedures Codes
The CPT 81350 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 81350 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 |
|---|---|---|
| 81349-CPT | High | Cytogenomic (Genome-Wide) Anal, Cytogenomic (Genome-Wide) Analysis For Constitutional Chromosomal Abnormalities Interrogation Of Genomic Regions For Copy Number And Loss-Of-Heterozygosity Variants Low-Pass Sequencing Analysis |
| 81350-CPT | Low | Ugt1a1 Gene Common Variants, Ugt1a1 Udp Glucuronosyltransferase 1 Family Polypeptide A1 Eg Drug Metabolism Hereditary Unconjugated Hyperbilirubinemia Gilbert Syndrome Gene Analysis Common Variants Eg 28 36 37 |
| 81351-CPT | Moderate | Tp53 (Tumor Protein 53) Gene Analysis; Full Gene, Tp53 (Tumor Protein 53) (Eg Li-Fraumeni Syndrome) Gene Analysis; Full Gene Sequence |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81350. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81350 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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