CPT 81408 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 XU - Unusual Non-Overlapping Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 81408 |
National average reimbursement for CPT 81408 by major payers:
$1,596.28
$1,224.08
$1,806.17
$2,854.95
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 81408 | $9265.59 | 1285361709 - SONYA WATSON | 954377219 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81408 | $3243.28 | 1356749089 - LAUREN MATTAS | 260089066 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81408 | $840.00 | 1952324022 - JULIAN MARTINEZ | 954786125 - (CA) SERRA COMMUNITY MEDICAL CLINIC, INC. | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81408 | $8153.60 | 1285361709 - SONYA WATSON | 954377219 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81408 | $8153.60 | 1356479307 - APARNA MURALI | 954377219 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81408 | $840.00 | 1154493476 - FRED LEVINE | 464150987 - (CA) VALLEY CHILDRENS MEDICAL GROUP | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81408 | $2090.00 | 1710175609 - OANA VELE | 453023019 - (NY) NORTH SHORE-LIJ MEDICAL PC | CA | Molecular Genetic Pathology (Medical Genetics) Physician (207SM0001X) |
United | 81408 | $6965.79 | 1487744330 - ALBERT LA SPADA | 954137974 | CA | Clinical Genetics (M.D.) Physician (207SG0201X) |
United | 81408 | $3365.58 | 1710175609 - OANA VELE | 453023019 - (NY) NORTH SHORE-LIJ MEDICAL PC | CA | Molecular Genetic Pathology (Medical Genetics) Physician (207SM0001X) |
United | 81408 | $8153.60 | 1235165796 - WAYNE GRODY | 954372298 | CA | Molecular Genetic Pathology (Pathology) Physician (207ZP0007X) |
United | 81408 | $9265.59 | 1972950665 - WENDY CONLON | 954373071 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81408 | $8227.79 | 1235753658 - FARIA AHMED | 680334324 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81408 | $5146.00 | 1255728713 - SOPHIA CEULEMANS | 951691313 - RADY CHILDRENS HOSPITAL-SAN DIEGO | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81408 | $9265.59 | 1134808595 - BAILEY LEAL | 954377219 | CA | Genetic Counselor (M.S.) (170300000X) |
United | 81408 | $9265.59 | 1235165796 - WAYNE GRODY | 954372298 | CA | Molecular Genetic Pathology (Pathology) Physician (207ZP0007X) |
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 81408 vs. Other Molecular Pathology Procedures Codes
The CPT 81408 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 81408 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 |
|---|---|---|
| 81408-CPT | High | Mopath Procedure Level 9, Molecular Pathology Procedure Level 9 (Eg Analysis Of >50 Exons In A Single Gene By Dna Sequence Analysis) Abca4 (Atp-Binding Cassette Sub-Family A [Abc1] Member 4) (Eg Stargardt Disease Age-Related Macular Degeneration) Full Gene Sequence Atm (Ataxia Telangiectasia Mutated) (Eg Ataxia Telangiectasia) Full Gene Sequence Cdh23 (Cadherin-Related 23) (Eg Usher Syndrome Type 1) Full Gene Sequence Cep290 (Centrosomal Protein 290kda) (Eg Joubert Syndrome) Full Gene Sequence Col1a1 (Collagen Type I Alpha 1) (Eg Osteogenesis Imperfecta Type I) Full Gene Sequence Col1a2 (Collagen Type I Alpha 2) (Eg Osteogenesis Imperfecta Type I) Full Gene Sequence Col4a1 (Collagen Type Iv Alpha 1) (Eg Brain Small-Vessel Disease With Hemorrhage) Full Gene Sequence Col4a3 (Collagen Type Iv Alpha 3 [Goodpasture Antigen]) (Eg Alport Syndrome) Full Gene Sequence Col4a5 (Collagen Type Iv Alpha 5) (Eg Alport Syndrome) Full Gene Sequence Dmd (Dystrophin) (Eg Duchenne Becker Muscular Dystrophy) Full Gene Sequence Dysf (Dysferlin Limb Girdle Muscular Dystrophy 2b [Autosomal Recessive]) (Eg Limb-Girdle Muscular Dystrophy) Full Gene Sequence Fbn1 (Fibrillin 1) (Eg Marfan Syndrome) Full Gene Sequence Itpr1 (Inositol 145-Trisphosphate Receptor Type 1) (Eg Spinocerebellar Ataxia) Full Gene Sequence Lama2 (Laminin Alpha 2) (Eg Congenital Muscular Dystrophy) Full Gene Sequence Lrrk2 (Leucine-Rich Repeat Kinase 2) (Eg Parkinson Disease) Full Gene Sequence Myh11 (Myosin Heavy Chain 11 Smooth Muscle) (Eg Thoracic Aortic Aneurysms And Aortic Dissections) Full Gene Sequence Neb (Nebulin) (Eg Nemaline Myopathy 2) Full Gene Sequence Nf1 (Neurofibromin 1) (Eg Neurofibromatosis Type 1) Full Gene Sequence Pkhd1 (Polycystic Kidney And Hepatic Disease 1) (Eg Autosomal Recessive Polycystic Kidney Disease) Full Gene Sequence Ryr1 (Ryanodine Receptor 1 Skeletal) (Eg Malignant Hyperthermia) Full Gene Sequence Ryr2 (Ryanodine Receptor 2 [Cardiac]) (Eg Catecholaminergic Polymorphic Ventricular Tachycardia Arrhythmogenic Right Ventricular Dysplasia) Full Gene Sequence Or Targeted Sequence Analysis Of > 50 Exons Ush2a (Usher Syndrome 2a [Autosomal Recessive Mild]) (Eg Usher Syndrome Type 2) Full Gene Sequence Vps13b (Vacuolar Protein Sorting 13 Homolog B [Yeast]) (Eg Cohen Syndrome) Full Gene Sequence Vwf (Von Willebrand Factor) (Eg Von Willebrand Disease Types 1 And 3) Full Gene Sequence |
| 81410-CPT | Moderate | Aortic Dysfunction Dilation, Aortic Dysfunction Or Dilation Eg Marfan Syndrome Loeys Dietz Syndrome Ehler Danlos Syndrome Type Iv Arterial Tortuosity Syndrome Genomic Sequence Analysis Panel Must Include Sequencing Of At Least 9 Genes Including Fbn1 Tgfbr1 Tgfbr2 Col3a1 Myh11 Acta2 Slc2a10 Smad3 And Mylk |
| 81411-CPT | High | Aortic Dysfunction Dilation, Aortic Dysfunction Or Dilation Eg Marfan Syndrome Loeys Dietz Syndrome Ehler Danlos Syndrome Type Iv Arterial Tortuosity Syndrome Duplication Deletion Analysis Panel Must Include Analyses For Tgfbr1 Tgfbr2 Myh11 And Col3a1 |
| 81412-CPT | High | Ashkenazi Jewish Assoc Dis, Ashkenazi Jewish Associated Disorders Eg Bloom Syndrome Canavan Disease Cystic Fibrosis Familial Dysautonomia Fanconi Anemia Group C Gaucher Disease Tay Sachs Disease Genomic Sequence Analysis Panel Must Include Sequencing Of At Least 9 Genes Including Aspa Blm Cftr Fancc Gba Hexa Ikbkap Mcoln1 And Smpd1 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81408. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81408 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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