CPT 81377 Fee Schedule
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.
| 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 81377 |
National average reimbursement for CPT 81377 by major payers:
$81.40
$66.67
$95.36
$169.84
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 81377 | ||||||
United | 81377 | $52.53 | 1366428401 - AARON ASKEW | 911750212 - DESERT BONE & JOINT SPECIALISTS, LLP | OR | Orthopaedic Trauma Physician (207XX0801X) |
United | 81377 | $39.79 | 1447207428 - KARIM SAYAD | 113256411 | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $96.91 | 1780608422 - HILLEL TOBIAS | 810861452 - (NY) MARCUS AVENUE MEDICAL PC | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $42.63 | 1932169307 - IRINA BERLIN | 200634255 - (NY) IRINA BERLIN MEDICAL PC | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $56.84 | 1427214949 - GASTROENTEROLOGY & NUTRITION, PC | 263032573 - (NY) GASTROENTEROLOGY & NUTRITION, P.C. | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $59.16 | 1417343989 - FREDERICK YICK | 264709927 - WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES, P.C | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $173.36 | 1174836712 - MOLHAM ABDULSAMAD | 236291113 - GEISINGER CLINIC | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $94.73 | 1508253303 - MICHAEL LI | 943281660 | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $56.22 | 1225002751 - HOWARD BRADNOCK | 113639647 - (NY) HOWARD W BRADNOCK MD PC | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $33.81 | 1487636254 - JAMES PULEO | 113466729 - (NY) GASTROINTESTINAL CARE OF LONG IS | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $56.84 | 1477842912 - GURSHAWN SINGH | 232380812 - ST LUKES PHYSICIAN GROUP INC | OH | Gastroenterology Physician (207RG0100X) |
United | 81377 | $56.84 | 1134264740 - MICHEL KAHALEH | 223371727 | VA | Gastroenterology Physician (207RG0100X) |
United | 81377 | $197.82 | 1245375088 - CHARLES SILVERA | 131623978 | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $33.15 | 1538169461 - MURALI PERUMAL | 61494923 - (NY) HORIZON FAMILY MEDICAL GROUP | NY | Gastroenterology Physician (207RG0100X) |
United | 81377 | $94.74 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 81377 vs. Other Molecular Pathology Procedures Codes
The CPT 81377 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 81377 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 |
|---|---|---|
| 81376-CPT | Low | Hla Class Ii Typing Low Resolution (Eg Antigen Equivalents); One Locus (Eg Hla-Drb1 -Drb3/4/5 -Dqb1 -Dqa1 -Dpb1 Or -Dpa1) Each (Revised 01/01/2014) |
| 81377-CPT | Low | Hla Class Ii Typing, Low Resolution (Eg, Antigen Equivalents); One Antigen Equivalent, Each |
| 81378-CPT | Moderate | Hla Class I And Ii Typing High Resolution (Ie Alleles Or Allele Groups); Complete (Ie Hla-A -B -C And -Drb1) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81377. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81377 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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