CPT 81403 Fee Schedule
Last Verified: August 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.
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)
| 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 81403 |
National average reimbursement for CPT 81403 by major payers:
$172.56
$113.39
$173.79
$289.28
Preview provider-level rates for...
For billing codeCPT 81403
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 81403 | $185.01 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 81403 | $77.78 | 1366428401 - AARON ASKEW | 931261079 - THE ORTHOPEDIC AND NEUROSURGICAL CENTER OF THE CASCADES | OR | Orthopaedic Trauma Physician (207XX0801X) |
United | 81403 | $77.78 | 1073515912 - MARK VITAL | 760512625 - HEA CLINIC, P.A. | TX | Ophthalmology Physician (207W00000X) |
United | 81403 | $185.01 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 81403 | $185.01 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 81403 | $100.01 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 81403 | $111.12 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 81403 | $407.44 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 81403 | $136.57 | 1033117007 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 81403 | $77.77 | 1386965267 - RENAL CONSULTANTS MEDICAL GROUP | 953841576 - (CA) RENAL CONSULTANTS MEDICAL GROUP | CA | Nephrology Physician (207RN0300X) |
United | 81403 | $64.81 | 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 | 81403 | $77.77 | 1891774519 - LEON HOME HEALTH, LLC, LEON AT HOME | 261288029 | FL | Home Health Agency (251E00000X) |
United | 81403 | $136.57 | 1821097627 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 81403 | $247.58 | 1528199890 - MOUNTAINSIDE FAMILY PRACTICE ASSOCIATES | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Family Medicine Physician (207Q00000X) |
United | 81403 | $111.12 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
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 81403 vs. Other Molecular Pathology Procedures Codes
The CPT 81403 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 81403 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 |
|---|---|---|
| 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) |
| 81404-CPT | Moderate | Mopath Procedure Level 5, Molecular Pathology Procedure Level 5 (Eg Analysis Of 2-5 Exons By Dna Sequence Analysis Mutation Scanning Or Duplication Deletion Variants Of 6-10 Exons Or Characterization Of A Dynamic Mutation Disorder Triplet Repeat By Southern Blot Analysis) Acads (Acyl-Coa Dehydrogenase C-2 To C-3 Short Chain) (Eg Short Chain Acyl-Coa Dehydrogenase Deficiency) Targeted Sequence Analysis (Eg Exons 5 And 6) Aqp2 (Aquaporin 2 [Collecting Duct]) (Eg Nephrogenic Diabetes Insipidus) Full Gene Sequence Arx (Aristaless Related Homeobox) (Eg X-Linked Lissencephaly With Ambiguous Genitalia X-Linked Intellectual Disability) Full Gene Sequence Avpr2 (Arginine Vasopressin Receptor 2) (Eg Nephrogenic Diabetes Insipidus) Full Gene Sequence Bbs10 (Bardet-Biedl Syndrome 10) (Eg Bardet-Biedl Syndrome) Full Gene Sequence Btd (Biotinidase) (Eg Biotinidase Deficiency) Full Gene Sequence C10orf2 (Chromosome 10 Open Reading Frame 2) (Eg Mitochondrial Dna Depletion Syndrome) Full Gene Sequence Cav3 (Caveolin 3) (Eg Cav3-Related Distal Myopathy Limb-Girdle Muscular Dystrophy Type 1c) Full Gene Sequence Cd40lg (Cd40 Ligand) (Eg X-Linked Hyper Igm Syndrome) Full Gene Sequence Cdkn2a (Cyclin-Dependent Kinase Inhibitor 2a) (Eg Cdkn2a-Related Cutaneous Malignant Melanoma Familial Atypical Mole-Malignant Melanoma Syndrome) Full Gene Sequence Clrn1 (Clarin 1) (Eg Usher Syndrome Type 3) Full Gene Sequence Cox6b1 (Cytochrome C Oxidase Subunit Vib Polypeptide 1) (Eg Mitochondrial Respiratory Chain Complex Iv Deficiency) Full Gene Sequence Cpt2 (Carnitine Palmitoyltransferase 2) (Eg Carnitine Palmitoyltransferase Ii Deficiency) Full Gene Sequence Crx (Cone-Rod Homeobox) (Eg Cone-Rod Dystrophy 2 Leber Congenital Amaurosis) Full Gene Sequence Cyp1b1 (Cytochrome P450 Family 1 Subfamily B Polypeptide 1) (Eg Primary Congenital Glaucoma) Full Gene Sequence Egr2 (Early Growth Response 2) (Eg Charcot-Marie-Tooth) Full Gene Sequence Emd (Emerin) (Eg Emery-Dreifuss Muscular Dystrophy) Duplication Deletion Analysis Epm2a (Epilepsy Progressive Myoclonus Type 2a Lafora Disease [Laforin]) (Eg Progressive Myoclonus Epilepsy) Full Gene Sequence Fgf23 (Fibroblast Growth Factor 23) (Eg Hypophosphatemic Rickets) Full Gene Sequence Fgfr2 (Fibroblast Growth Factor Receptor 2) (Eg Craniosynostosis Apert Syndrome Crouzon Syndrome) Targeted Sequence Analysis (Eg Exons 8 10) Fgfr3 (Fibroblast Growth Factor Receptor 3) (Eg Achondroplasia Hypochondroplasia) Targeted Sequence Analysis (Eg Exons 8 11 12 13) Fhl1 (Four And A Half Lim Domains 1) (Eg Emery-Dreifuss Muscular Dystrophy) Full Gene Sequence Fkrp (Fukutin Related Protein) (Eg Congenital Muscular Dystrophy Type 1c [Mdc1c] Limb-Girdle Muscular Dystrophy [Lgmd] Type 2i) Full Gene Sequence Foxg1 (Forkhead Box G1) (Eg Rett Syndrome) Full Gene Sequence Fshmd1a (Facioscapulohumeral Muscular Dystrophy 1a) (Eg Facioscapulohumeral Muscular Dystrophy) Evaluation To Detect Abnormal (Eg Deleted) Alleles Fshmd1a (Facioscapulohumeral Muscular Dystrophy 1a) (Eg Facioscapulohumeral Muscular Dystrophy) Characterization Of Haplotype(S) (Ie Chromosome 4a And 4b Haplotypes) Gh1 (Growth Hormone 1) (Eg Growth Hormone Deficiency) Full Gene Sequence Gp1bb (Glycoprotein Ib [Platelet] Beta Polypeptide) (Eg Bernard-Soulier Syndrome Type B) Full Gene Sequence (For Common Deletion Variants Of Alpha Globin 1 And Alpha Globin 2 Genes Use 81257) Hnf1b (Hnf1 Homeobox B) (Eg Maturity-Onset Diabetes Of The Young [Mody]) Duplication Deletion Analysis Hras (V-Ha-Ras Harvey Rat Sarcoma Viral Oncogene Homolog) (Eg Costello Syndrome) Full Gene Sequence Hsd3b2 (Hydroxy-Delta-5-Steroid Dehydrogenase 3 Beta- And Steroid Delta-Isomerase 2) (Eg 3-Beta-Hydroxysteroid Dehydrogenase Type Ii Deficiency) Full Gene Sequence Hsd11b2 (Hydroxysteroid [11-Beta] Dehydrogenase 2) (Eg Mineralocorticoid Excess Syndrome) Full Gene Sequence Hspb1 (Heat Shock 27kda Protein 1) (Eg Charcot-Marie-Tooth Disease) Full Gene Sequence Ins (Insulin) (Eg Diabetes Mellitus) Full Gene Sequence Kcnj1 (Potassium Inwardly-Rectifying Channel Subfamily J Member 1) (Eg Bartter Syndrome) Full Gene Sequence Kcnj10 (Potassium Inwardly-Rectifying Channel Subfamily J Member 10) (Eg Sesame Syndrome East Syndrome Sensorineural Hearing Loss) Full Gene Sequence Litaf (Lipopolysaccharide-Induced Tnf Factor) (Eg Charcot-Marie-Tooth) Full Gene Sequence Mefv (Mediterranean Fever) (Eg Familial Mediterranean Fever) Full Gene Sequence Men1 (Multiple Endocrine Neoplasia I) (Eg Multiple Endocrine Neoplasia Type 1 Wermer Syndrome) Duplication Deletion Analysis Mmachc (Methylmalonic Aciduria [Cobalamin Deficiency] Cblc Type With Homocystinuria) (Eg Methylmalonic Acidemia And Homocystinuria) Full Gene Sequence Mpv17 (Mpv17 Mitochondrial Inner Membrane Protein) (Eg Mitochondrial Dna Depletion Syndrome) Duplication Deletion Analysis Ndp (Norrie Disease [Pseudoglioma]) (Eg Norrie Disease) Full Gene Sequence Ndufa1 (Nadh Dehydrogenase [Ubiquinone] 1 Alpha Subcomplex 1 7.5kda) (Eg Leigh Syndrome Mitochondrial Complex I Deficiency) Full Gene Sequence Ndufaf2 (Nadh Dehydrogenase [Ubiquinone] 1 Alpha Subcomplex Assembly Factor 2) (Eg Leigh Syndrome Mitochondrial Complex I Deficiency) Full Gene Sequence Ndufs4 (Nadh Dehydrogenase [Ubiquinone] Fe-S Protein 4 18kda [Nadh-Coenzyme Q Reductase]) (Eg Leigh Syndrome Mitochondrial Complex I Deficiency) Full Gene Sequence Nipa1 (Non-Imprinted In Prader-Willi Angelman Syndrome 1) (Eg Spastic Paraplegia) Full Gene Sequence Nlgn4x (Neuroligin 4 X-Linked) (Eg Autism Spectrum Disorders) Duplication Deletion Analysis Npc2 (Niemann-Pick Disease Type C2 [Epididymal Secretory Protein E1]) (Eg Niemann-Pick Disease Type C2) Full Gene Sequence Nr0b1 (Nuclear Receptor Subfamily 0 Group B Member 1) (Eg Congenital Adrenal Hypoplasia) Full Gene Sequence Pdx1 (Pancreatic And Duodenal Homeobox 1) (Eg Maturity-Onset Diabetes Of The Young [Mody]) Full Gene Sequence Phox2b (Paired-Like Homeobox 2b) (Eg Congenital Central Hypoventilation Syndrome) Full Gene Sequence Plp1 (Proteolipid Protein 1) (Eg Pelizaeus-Merzbacher Disease Spastic Paraplegia) Duplication Deletion Analysis Pqbp1 (Polyglutamine Binding Protein 1) (Eg Renpenning Syndrome) Duplication Deletion Analysis Prnp (Prion Protein) (Eg Genetic Prion Disease) Full Gene Sequence Prop1 (Prop Paired-Like Homeobox 1) (Eg Combined Pituitary Hormone Deficiency) Full Gene Sequence Prph2 (Peripherin 2 [Retinal Degeneration Slow]) (Eg Retinitis Pigmentosa) Full Gene Sequence Prss1 (Protease Serine 1 [Trypsin 1]) (Eg Hereditary Pancreatitis) Full Gene Sequence Raf1 (V-Raf-1 Murine Leukemia Viral Oncogene Homolog 1) (Eg Leopard Syndrome) Targeted Sequence Analysis (Eg Exons 7 12 14 17) Ret (Ret Proto-Oncogene) (Eg Multiple Endocrine Neoplasia Type 2b And Familial Medullary Thyroid Carcinoma) Common Variants (Eg M918t 2647 2648delinstt A883f) Rho (Rhodopsin) (Eg Retinitis Pigmentosa) Full Gene Sequence Rp1 (Retinitis Pigmentosa 1) (Eg Retinitis Pigmentosa) Full Gene Sequence Scn1b (Sodium Channel Voltage-Gated Type I Beta) (Eg Brugada Syndrome) Full Gene Sequence Sco2 (Sco Cytochrome Oxidase Deficient Homolog 2 [Sco1l]) (Eg Mitochondrial Respiratory Chain Complex Iv Deficiency) Full Gene Sequence Sdhc (Succinate Dehydrogenase Complex Subunit C Integral Membrane Protein 15kda) (Eg Hereditary Paraganglioma-Pheochromocytoma Syndrome) Duplication Deletion Analysis Sdhd (Succinate Dehydrogenase Complex Subunit D Integral Membrane Protein) (Eg Hereditary Paraganglioma) Full Gene Sequence Sgcg (Sarcoglycan Gamma [35kda Dystrophin-Associated Glycoprotein]) (Eg Limb-Girdle Muscular Dystrophy) Duplication Deletion Analysis Sh2d1a (Sh2 Domain Containing 1a) (Eg X-Linked Lymphoproliferative Syndrome) Full Gene Sequence Slc16a2 (Solute Carrier Family 16 Member 2 [Thyroid Hormone Transporter]) (Eg Specific Thyroid Hormone Cell Transporter Deficiency Allan-Herndon-Dudley Syndrome) Duplication Deletion Analysis Slc25a20 (Solute Carrier Family 25 [Carnitine Acylcarnitine Translocase] Member 20) (Eg Carnitine-Acylcarnitine Translocase Deficiency) Duplication Deletion Analysis Slc25a4 (Solute Carrier Family 25 [Mitochondrial Carrier Adenine Nucleotide Translocator] Member 4) (Eg Progressive External Ophthalmoplegia) Full Gene Sequence Sod1 (Superoxide Dismutase 1 Soluble) (Eg Amyotrophic Lateral Sclerosis) Full Gene Sequence Spink1 (Serine Peptidase Inhibitor Kazal Type 1) (Eg Hereditary Pancreatitis) Full Gene Sequence Stk11 (Serine Threonine Kinase 11) (Eg Peutz-Jeghers Syndrome) Duplication Deletion Analysis Taco1 (Translational Activator Of Mitochondrial Encoded Cytochrome C Oxidase I) (Eg Mitochondrial Respiratory Chain Complex Iv Deficiency) Full Gene Sequence Thap1 (Thap Domain Containing Apoptosis Associated Protein 1) (Eg Torsion Dystonia) Full Gene Sequence Tor1a (Torsin Family 1 Member A [Torsin A]) (Eg Torsion Dystonia) Full Gene Sequence Ttpa (Tocopherol [Alpha] Transfer Protein) (Eg Ataxia) Full Gene Sequence Ttr (Transthyretin) (Eg Familial Transthyretin Amyloidosis) Full Gene Sequence Twist1 (Twist Homolog 1 [Drosophila]) (Eg Saethre-Chotzen Syndrome) Full Gene Sequence Tyr (Tyrosinase [Oculocutaneous Albinism Ia]) (Eg Oculocutaneous Albinism Ia) Full Gene Sequence Ugt1a1 (Udp Glucuronosyltransferase 1 Family Polypeptide A1) (Eg Hereditary Unconjugated Hyperbilirubinemia [Crigler-Najjar Syndrome]) Full Gene Sequence Ush1g (Usher Syndrome 1g [Autosomal Recessive]) (Eg Usher Syndrome Type 1) Full Gene Sequence Vhl (Von Hippel-Lindau Tumor Suppressor) (Eg Von Hippel-Lindau Familial Cancer Syndrome) Full Gene Sequence Vwf (Von Willebrand Factor) (Eg Von Willebrand Disease Type 1c) Targeted Sequence Analysis (Eg Exons 26 27 37) Zeb2 (Zinc Finger E-Box Binding Homeobox 2) (Eg Mowat-Wilson Syndrome) Duplication Deletion Analysis Znf41 (Zinc Finger Protein 41) (Eg X-Linked Intellectual Disability 89) Full Gene Sequence |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81403. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81403 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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