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See a sample rate comparisonCPT 81362 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) Known Familial Variant(S) (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 XU - Unusual Non-Overlapping Service 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 81362 |
| Medicaid Fee Schedule | View Medicaid rates for 81362 |
National average reimbursement for CPT 81362 by major payers:
$343.46
$224.08
$343.86
$534.14
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CPT 81362
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$825.55Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$375.25Published rateRolando Henriquez
Progressive Medical Center, S.C.
$206.38Published rateBrittany Ptachick
Hroa 401k Plan
$157.61Published rateProgressive Emergency Physicians PLLC
$136.64Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 81362 vs. Other Molecular Pathology Procedures Codes
The CPT 81362 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 81362 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 |
|---|---|---|
| 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) |
| 81363-CPT | Low | Hbb (Hemoglobin Subunit Beta), Hbb (Hemoglobin Subunit Beta) (Eg Sickle Cell Anemia Beta Thalassemia Hemoglobinopathy) Duplicationdeletion 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 81362. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81362 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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