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See a sample rate comparisonCPT 81376 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.
Transplant Match Genetic Test, A Lab Analysis That Identifies The Type Of Human Leukocyte Antigen (Hla). The Result Is Used To Identify The Best Donor And Recipient For Bone Marrow Or Cord Blood.
| 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 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81376 |
| Medicaid Fee Schedule | View Medicaid rates for 81376 |
National average reimbursement for CPT 81376 by major payers:
$106.02
$87.54
$122.46
$199.68
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CPT 81376
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$268.88Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$145.20Published rateCharleston Radiologists PA
Charleston Radiologists, P.A.
$83.37Published rateLeon Home Health, LLC, Leon At Home
$69.84Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$42.77Published rate
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See a sample payer proposalCPT 81376 vs. Other Molecular Pathology Procedures Codes
The CPT 81376 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 81376 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 |
|---|---|---|
| 81375-CPT | Low | Transplant Match Genetic Test, A Lab Analysis That Identifies The Type Of Human Leukocyte Antigen (Hla). The Result Is Used To Identify The Best Donor And Recipient For Bone Marrow Or Cord Blood. |
| 81376-CPT | Low | Transplant Match Genetic Test, A Lab Analysis That Identifies The Type Of Human Leukocyte Antigen (Hla). The Result Is Used To Identify The Best Donor And Recipient For Bone Marrow Or Cord Blood. |
| 81377-CPT | Low | Transplant Match Genetic Test, A Lab Analysis That Identifies The Type Of Human Leukocyte Antigen (Hla). The Result Is Used To Identify The Best Donor And Recipient For Bone Marrow Or Cord Blood. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81376. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81376 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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