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See a sample rate comparisonCPT 81361 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.
Hbb (Hemoglobin Subunit Beta), Hbb (Hemoglobin Subunit Beta) (Eg Sickle Cell Anemia Beta Thalassemia Hemoglobinopathy) Common Variant(S) (Eg Hbs Hbc Hbe) (Eg Exon 12) Hpa-9ab (V837m)
| 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 XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81361 |
| Medicaid Fee Schedule | View Medicaid rates for 81361 |
National average reimbursement for CPT 81361 by major payers:
$161.35
$107.15
$161.79
$260.86
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CPT 81361
5 of 25 sample ratesHigher to lower in this preview
Soghra Jougheh Doust
$959.28Published rateDayna Richards
$712.66Published rateHayley Wright
$283.48Published rateHind Al Saif
$174.80Published rateAnna Villa
Blanchard Valley Regional Health Center
$104.88Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81361 vs. Other Molecular Pathology Procedures Codes
The CPT 81361 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 81361 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 |
|---|---|---|
| 81360-CPT | Low | Zrsr2 Gene Common Variants, Zrsr2 Zinc Finger Ccch Type Rna Binding Motif And Serine Arginine Rich 2 Eg Myelodysplastic Syndrome Acute Myeloid Leukemia Gene Analysis Common Variant S Eg E65fs E122fs R448fs |
| 81361-CPT | Low | Hbb (Hemoglobin Subunit Beta), Hbb (Hemoglobin Subunit Beta) (Eg Sickle Cell Anemia Beta Thalassemia Hemoglobinopathy) Common Variant(S) (Eg Hbs Hbc Hbe) (Eg Exon 12) Hpa-9ab (V837m) |
| 81362-CPT | Moderate | Hbb (Hemoglobin Subunit Beta), Hbb (Hemoglobin Subunit Beta) (Eg Sickle Cell Anemia Beta Thalassemia Hemoglobinopathy) Known Familial Variant(S) (Eg Exon 12) Hpa-9ab (V837m) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81361. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81361 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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