CPT 81402 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 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 81402 |
National average reimbursement for CPT 81402 by major payers:

$137.66

$92.11

$139.13

$241.20
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 81402 | $110.86 | 1013915149 - BAYCARE HOME CARE, INC., DBA SARASOTA MEMORIAL HOME CARE | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 81402 | $110.86 | 1821097627 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 81402 | $195.11 | 1437126745 - ALAN MELTZER | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Pediatrics Physician (208000000X) |
United | 81402 | $330.73 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 81402 | $63.14 | 1073515912 - MARK VITAL | 760512625 - HEA CLINIC, P.A. | TX | Ophthalmology Physician (207W00000X) |
United | 81402 | $110.86 | 1720087513 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 81402 | $150.33 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 81402 | $82.68 | 1164776688 - NICOLE SCHWAB | 362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C. | IL | Family Nurse Practitioner (363LF0000X) |
United | 81402 | $90.20 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 81402 | $330.73 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 81402 | $90.20 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 81402 | $63.13 | 1447317110 - BAPTIST HEALTH CARE, INC., BAPTIST HOME HEALT CARE AND MEDICAL EQUIPMENT | 590657322 - BAPTIST HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 81402 | $90.20 | 1578583647 - MARC STIEFEL | 202604678 - PINNACLE ENT ALLIANCE, LLC | PA | Otolaryngology Physician (207Y00000X) |
United | 81402 | $52.61 | 1598375651 - E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC, E AND A HEALTHCARE ON THE GO | 832289173 - (FL) E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC | FL | Home Health Agency (251E00000X) |
United | 81402 | $330.73 | 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 81402 vs. Other Molecular Pathology Procedures Codes
The CPT 81402 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 81402 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 |
|---|---|---|
| 81401-CPT | Low | Mopath Procedure Level 2, Molecular Pathology Procedure Level 2 (Eg 2-10 Snps 1 Methylated Variant Or 1 Somatic Variant [Typically Using Nonsequencing Target Variant Analysis] Or Detection Of A Dynamic Mutation Disorder Triplet Repeat) Abcc8 (Atp-Binding Cassette Sub-Family C [Cftr Mrp] Member 8) (Eg Familial Hyperinsulinism) Common Variants (Eg C.3898-9g>A [C.3992-9g>A] F1388del) Abl1 (Abl Proto-Oncogene 1 Non-Receptor Tyrosine Kinase) (Eg Acquired Imatinib Resistance) T315i Variant Acadm (Acyl-Coa Dehydrogenase C-4 To C-12 Straight Chain Mcad) (Eg Medium Chain Acyl Dehydrogenase Deficiency) Commons Variants (Eg K304e Y42h) Adrb2 (Adrenergic Beta-2 Receptor Surface) (Eg Drug Metabolism) Common Variants (Eg G16r Q27e) Apob (Apolipoprotein B) (Eg Familial Hypercholesterolemia Type B) Common Variants (Eg R3500q R3500w) Apoe (Apolipoprotein E) (Eg Hyperlipoproteinemia Type Iii Cardiovascular Disease Alzheimer Disease) Common Variants (Eg *2 *3 *4) Cbfb Myh11 (Inv(16)) (Eg Acute Myeloid Leukemia) Qualitative And Quantitative If Performed Cbs (Cystathionine-Beta-Synthase) (Eg Homocystinuria Cystathionine Beta-Synthase Deficiency) Common Variants (Eg I278t G307s) Cfh Arms2 (Complement Factor H Age-Related Maculopathy Susceptibility 2) (Eg Macular Degeneration) Common Variants (Eg Y402h [Cfh] A69s [Arms2]) Dek Nup214 (T(6 9)) (Eg Acute Myeloid Leukemia) Translocation Analysis Qualitative And Quantitative If Performed E2a Pbx1 (T(1 19)) (Eg Acute Lymphocytic Leukemia) Translocation Analysis Qualitative And Quantitative If Performed Eml4 Alk (Inv(2)) (Eg Non-Small Cell Lung Cancer) Translocation Or Inversion Analysis Etv6 Runx1 (T(12 21)) (Eg Acute Lymphocytic Leukemia) Translocation Analysis Qualitative And Quantitative If Performed Ewsr1 Atf1 (T(12 22)) (Eg Clear Cell Sarcoma) Translocation Analysis Qualitative And Quantitative If Performed Ewsr1 Erg (T(21 22)) (Eg Ewing Sarcoma Peripheral Neuroectodermal Tumor) Translocation Analysis Qualitative And Quantitative If Performed Ewsr1 Fli1 (T(11 22)) (Eg Ewing Sarcoma Peripheral Neuroectodermal Tumor) Translocation Analysis Qualitative And Quantitative If Performed Ewsr1 Wt1 (T(11 22)) (Eg Desmoplastic Small Round Cell Tumor) Translocation Analysis Qualitative And Quantitative If Performed F11 (Coagulation Factor Xi) (Eg Coagulation Disorder) Common Variants (Eg E117x [Type Ii] F283l [Type Iii] Ivs14del14 And Ivs14+1g>A [Type I]) Fgfr3 (Fibroblast Growth Factor Receptor 3) (Eg Achondroplasia Hypochondroplasia) Common Variants (Eg 1138g>A 1138g>C 1620c>A 1620c>G) Fip1l1 Pdgfra (Del[4q12]) (Eg Imatinib-Sensitive Chronic Eosinophilic Leukemia) Qualitative And Quantitative If Performed Flg (Filaggrin) (Eg Ichthyosis Vulgaris) Common Variants (Eg R501x 2282del4 R2447x S3247x 3702delg) Foxo1 Pax3 (T(2 13)) (Eg Alveolar Rhabdomyosarcoma) Translocation Analysis Qualitative And Quantitative If Performed Foxo1 Pax7 (T(1 13)) (Eg Alveolar Rhabdomyosarcoma) Translocation Analysis Qualitative And Quantitative If Performed Fus Ddit3 (T(12 16)) (Eg Myxoid Liposarcoma) Translocation Analysis Qualitative And Quantitative If Performed Galc (Galactosylceramidase) (Eg Krabbe Disease) Common Variants (Eg C.857g>A 30-Kb Deletion) Galt (Galactose-1-Phosphate Uridylyltransferase) (Eg Galactosemia) Common Variants (Eg Q188r S135l K285n T138m L195p Y209c Ivs2-2a>G P171s Del5kb N314d L218l N314d) H19 (Imprinted Maternally Expressed Transcript [Non-Protein Coding]) (Eg Beckwith-Wiedemann Syndrome) Methylation Analysis Igh@ Bcl2 (T(14 18)) (Eg Follicular Lymphoma) Translocation Analysis Single Breakpoint (Eg Major Breakpoint Region [Mbr] Or Minor Cluster Region [Mcr]) Qualitative Or Quantitative (When Both Mbr And Mcr Breakpoints Are Performed Use 81278) Kcnq1ot1 (Kcnq1 Overlapping Transcript 1 [Non-Protein Coding]) (Eg Beckwith-Wiedemann Syndrome) Methylation Analysis Linc00518 (Long Intergenic Non-Protein Coding Rna 518) (Eg Melanoma) Expression Analysis Lrrk2 (Leucine-Rich Repeat Kinase 2) (Eg Parkinson Disease) Common Variants (Eg R1441g G2019s I2020t) Med12 (Mediator Complex Subunit 12) (Eg Fg Syndrome Type 1 Lujan Syndrome) Common Variants (Eg R961w N1007s) Meg3 Dlk1 (Maternally Expressed 3 [Non-Protein Coding] Delta-Like 1 Homolog [Drosophila]) (Eg Intrauterine Growth Retardation) Methylation Analysis Mll Aff1 (T(4 11)) (Eg Acute Lymphoblastic Leukemia) Translocation Analysis Qualitative And Quantitative If Performed Mll Mllt3 (T(9 11)) (Eg Acute Myeloid Leukemia) Translocation Analysis Qualitative And Quantitative If Performed Mt-Atp6 (Mitochondrially Encoded Atp Synthase 6) (Eg Neuropathy With Ataxia And Retinitis Pigmentosa [Narp] Leigh Syndrome) Common Variants (Eg M.8993t>G M.8993t>C) Mt-Nd4 Mt-Nd6 (Mitochondrially Encoded Nadh Dehydrogenase 4 Mitochondrially Encoded Nadh Dehydrogenase 6) (Eg Leber Hereditary Optic Neuropathy [Lhon]) Common Variants (Eg M.11778g>A M.3460g>A M.14484t>C) Mt-Nd5 (Mitochondrially Encoded Trna Leucine 1 [Uua G] Mitochondrially Encoded Nadh Dehydrogenase 5) (Eg Mitochondrial Encephalopathy With Lactic Acidosis And Stroke-Like Episodes [Melas]) Common Variants (Eg M.3243a>G M.3271t>C M.3252a>G M.13513g>A) Mt-Rnr1 (Mitochondrially Encoded 12s Rna) (Eg Nonsyndromic Hearing Loss) Common Variants (Eg M.1555a>G M.1494c>T) Mt-Tk (Mitochondrially Encoded Trna Lysine) (Eg Myoclonic Epilepsy With Ragged-Red Fibers [Merrf]) Common Variants (Eg M.8344a>G M.8356t>C) Mt-Tl1 (Mitochondrially Encoded Trna Leucine 1 [Uua G]) (Eg Diabetes And Hearing Loss) Common Variants (Eg M.3243a>G M.14709 T>C) Mt-Tl1 Mt-Ts1 Mt-Rnr1 (Mitochondrially Encoded Trna Serine 1 [Ucn] Mitochondrially Encoded 12s Rna) (Eg Nonsyndromic Sensorineural Deafness [Including Aminoglycoside-Induced Nonsyndromic Deafness]) Common Variants (Eg M.7445a>G M.1555a>G) Mutyh (Muty Homolog [E. Coli]) (Eg Myh-Associated Polyposis) Common Variants (Eg Y165c G382d) Nod2 (Nucleotide-Binding Oligomerization Domain Containing 2) (Eg Crohns Disease Blau Syndrome) Common Variants (Eg Snp 8 Snp 12 Snp 13) Npm1 Alk (T(2 5)) (Eg Anaplastic Large Cell Lymphoma) Translocation Analysis Pax8 Pparg (T(2 3) (Q13 P25)) (Eg Follicular Thyroid Carcinoma) Translocation Analysis Prame (Preferentially Expressed Antigen In Melanoma) (Eg Melanoma) Expression Analysis Prss1 (Protease Serine 1 [Trypsin 1]) (Eg Hereditary Pancreatitis) Common Variants (Eg N29i A16v R122h) Pygm (Phosphorylase Glycogen Muscle) (Eg Glycogen Storage Disease Type V Mcardle Disease) Common Variants (Eg R50x G205s) Runx1 Runx1t1 (T(8 21)) (Eg Acute Myeloid Leukemia) Translocation Analysis Qualitative And Quantitative If Performed Ss18 Ssx1 (T(X 18)) (Eg Synovial Sarcoma) Translocation Analysis Qualitative And Quantitative If Performed Ss18 Ssx2 (T(X 18)) (Eg Synovial Sarcoma) Translocation Analysis Qualitative And Quantitative If Performed Vwf (Von Willebrand Factor) (Eg Von Willebrand Disease Type 2n) Common Variants (Eg T791m R816w R854q) |
| 81402-CPT | Low | Mopath Procedure Level 3, Molecular Pathology Procedure Level 3 Eg 10 Snps 2 10 Methylated Variants Or 2 10 Somatic Variants Typically Using Non Sequencing Target Variant Analysis Immunoglobulin And T Cell Receptor Gene Rearrangements Duplication Deletion Variants Of 1 Exon Loss Of Heterozygosity Loh Uniparental Disomy Upd Chromosome 1p 19q Eg Glial Tumors Deletion Analysis Chromosome 18q Eg D18s55 D18s58 D18s61 D18s64 And D18s69 Eg Colon Cancer Allelic Imbalance Assessment Ie Loss Of Heterozygosity Col1a1 Pdgfb T 17 22 Eg Dermatofibrosarcoma Protuberans Translocation Analysis Multiple Breakpoints Qualitative And Quantitative If Performed Cyp21a2 Cytochrome P450 Family 21 Subfamily A Polypeptide 2 Eg Congenital Adrenal Hyperplasia 21 Hydroxylase Deficiency Common Variants Eg Ivs2 13g P30l I172n Exon 6 Mutation Cluster I235n V236e M238k V281l L307ffsx6 Q318x R356w P453s G110vfsx21 30 Kb Deletion Variant Esr1 Pgr Receptor 1 Progesterone Receptor Ratio Eg Breast Cancer Mefv Mediterranean Fever Eg Familial Mediterranean Fever Common Variants Eg E148q P369s F479l M680i I692del M694v M694i K695r V726a A744s R761h Trd T Cell Antigen Receptor Delta Eg Leukemia And Lymphoma Gene Rearrangement Analysis Evaluation To Detect Abnormal Clonal Population Uniparental Disomy Upd Eg Russell Silver Syndrome Prader Willi Angelman Syndrome Short Tandem Repeat Str Analysis |
| 81403-CPT | Low | Mopath Procedure Level 4, Molecular Pathology Procedure Level 4 (Eg Analysis Of Single Exon By Dna Sequence Analysis Analysis Of >10 Amplicons Using Multiplex Pcr In 2 Or More Independent Reactions Mutation Scanning Or Duplication Deletion Variants Of 2-5 Exons) Ang (Angiogenin Ribonuclease Rnase A Family 5) (Eg Amyotrophic Lateral Sclerosis) Full Gene Sequence Arx (Aristaless Related Homeobox) (Eg X-Linked Lissencephaly With Ambiguous Genitalia X-Linked Intellectual Disability) Duplication Deletion Analysis Cel (Carboxyl Ester Lipase [Bile Salt-Stimulated Lipase]) (Eg Maturity-Onset Diabetes Of The Young [Mody]) Targeted Sequence Analysis Of Exon 11 (Eg C.1785delc C.1686delt) Ctnnb1 (Catenin [Cadherin-Associated Protein] Beta 1 88kda) (Eg Desmoid Tumors) Targeted Sequence Analysis (Eg Exon 3) Daz Sry (Deleted In Azoospermia And Sex Determining Region Y) (Eg Male Infertility) Common Deletions (Eg Azfa Azfb Azfc Azfd) Dnmt3a (Dna [Cytosine-5-]-Methyltransferase 3 Alpha) (Eg Acute Myeloid Leukemia) Targeted Sequence Analysis (Eg Exon 23) Epcam (Epithelial Cell Adhesion Molecule) (Eg Lynch Syndrome) Duplication Deletion Analysis F8 (Coagulation Factor Viii) (Eg Hemophilia A) Inversion Analysis Intron 1 And Intron 22a F12 (Coagulation Factor Xii [Hageman Factor]) (Eg Angioedema Hereditary Type Iii Factor Xii Deficiency) Targeted Sequence Analysis Of Exon 9 Fgfr3 (Fibroblast Growth Factor Receptor 3) (Eg Isolated Craniosynostosis) Targeted Sequence Analysis (Eg Exon 7) (For Targeted Sequence Analysis Of Multiple Fgfr3 Exons Use 81404) Gjb1 (Gap Junction Protein Beta 1) (Eg Charcot-Marie-Tooth X-Linked) Full Gene Sequence Gnaq (Guanine Nucleotide-Binding Protein G[Q] Subunit Alpha) (Eg Uveal Melanoma) Common Variants (Eg R183 Q209) Human Erythrocyte Antigen Gene Analyses (Eg Slc14a1 [Kidd Blood Group] Bcam [Lutheran Blood Group] Icam4 [Landsteiner-Wiener Blood Group] Slc4a1 [Diego Blood Group] Aqp1 [Colton Blood Group] Ermap [Scianna Blood Group] Rhce [Rh Blood Group Ccee Antigens] Kel [Kell Blood Group] Darc [Duffy Blood Group] Gypa Gypb Gype [Mns Blood Group] Art4 [Dombrock Blood Group]) (Eg Sickle-Cell Disease Thalassemia Hemolytic Transfusion Reactions Hemolytic Disease Of The Fetus Or Newborn) Common Variants Hras (V-Ha-Ras Harvey Rat Sarcoma Viral Oncogene Homolog) (Eg Costello Syndrome) Exon 2 Sequence Kcnc3 (Potassium Voltage-Gated Channel Shaw-Related Subfamily Member 3) (Eg Spinocerebellar Ataxia) Targeted Sequence Analysis (Eg Exon 2) Kcnj2 (Potassium Inwardly-Rectifying Channel Subfamily J Member 2) (Eg Andersen-Tawil Syndrome) Full Gene Sequence Kcnj11 (Potassium Inwardly-Rectifying Channel Subfamily J Member 11) (Eg Familial Hyperinsulinism) Full Gene Sequence Killer Cell Immunoglobulin-Like Receptor (Kir) Gene Family (Eg Hematopoietic Stem Cell Transplantation) Genotyping Of Kir Family Genes Known Familial Variant Not Otherwise Specified For Gene Listed In Tier 1 Or Tier 2 Or Identified During A Genomic Sequencing Procedure Dna Sequence Analysis Each Variant Exon (For A Known Familial Variant That Is Considered A Common Variant Use Specific Common Variant Tier 1 Or Tier 2 Code) Mc4r (Melanocortin 4 Receptor) (Eg Obesity) Full Gene Sequence Mica (Mhc Class I Polypeptide-Related Sequence A) (Eg Solid Organ Transplantation) Common Variants (Eg *001 *002) Mt-Rnr1 (Mitochondrially Encoded 12s Rna) (Eg Nonsyndromic Hearing Loss) Full Gene Sequence Mt-Ts1 (Mitochondrially Encoded Trna Serine 1) (Eg Nonsyndromic Hearing Loss) Full Gene Sequence Ndp (Norrie Disease [Pseudoglioma]) (Eg Norrie Disease) Duplication Deletion Analysis Nhlrc1 (Nhl Repeat Containing 1) (Eg Progressive Myoclonus Epilepsy) Full Gene Sequence Phox2b (Paired-Like Homeobox 2b) (Eg Congenital Central Hypoventilation Syndrome) Duplication Deletion Analysis Pln (Phospholamban) (Eg Dilated Cardiomyopathy Hypertrophic Cardiomyopathy) Full Gene Sequence Rhd (Rh Blood Group D Antigen) (Eg Hemolytic Disease Of The Fetus And Newborn Rh Maternal Fetal Compatibility) Deletion Analysis (Eg Exons 4 5 And 7 Pseudogene) Rhd (Rh Blood Group D Antigen) (Eg Hemolytic Disease Of The Fetus And Newborn Rh Maternal Fetal Compatibility) Deletion Analysis (Eg Exons 4 5 And 7 Pseudogene) Performed On Cell-Free Fetal Dna In Maternal Blood (For Human Erythrocyte Gene Analysis Of Rhd Use A Separate Unit Of 81403) Sh2d1a (Sh2 Domain Containing 1a) (Eg X-Linked Lymphoproliferative Syndrome) Duplication Deletion Analysis Twist1 (Twist Homolog 1 [Drosophila]) (Eg Saethre-Chotzen Syndrome) Duplication Deletion Analysis Uba1 (Ubiquitin-Like Modifier Activating Enzyme 1) (Eg Spinal Muscular Atrophy X-Linked) Targeted Sequence Analysis (Eg Exon 15) Vhl (Von Hippel-Lindau Tumor Suppressor) (Eg Von Hippel-Lindau Familial Cancer Syndrome) Deletion Duplication Analysis Vwf (Von Willebrand Factor) (Eg Von Willebrand Disease Types 2a 2b 2m) Targeted Sequence Analysis (Eg Exon 28) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81402. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81402 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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