Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 81411 Fee Schedule
Last Verified: October 2026
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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Genomic Sequencing Procedures and Other Molecular Multianalyte Assays |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 81411 |
| Medicaid Fee Schedule | View Medicaid rates for 81411 |
National average reimbursement for CPT 81411 by major payers:
$1,007.71
$826.92
$1,241.16
$1,885.71
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 81411.
CPT 81411
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$2,970.42Published rateChristopher Raio
St Joseph Hospital
$1,604.03Published rateChristopher Raio
St Joseph Hospital
$1,348.84Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$810.11Published 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
$472.57Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 81411 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes
The CPT 81411 code is part of the Pathology and Laboratory Procedures services used for Genomic Sequencing Procedures and Other Molecular Multianalyte Assays. 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 81411 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 |
|---|---|---|
| 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 |
| 81413-CPT | Moderate | Car Ion Chnnlpath Inc 10 Gns, Cardiac Ion Channelopathies Eg Brugada Syndrome Long Qt Syndrome Short Qt Syndrome Catecholaminergic Polymorphic Ventricular Tachycardia Genomic Sequence Analysis Panel Must Include Sequencing Of At Least 10 Genes Including Ank2 Casq2 Cav3 Kcne1 Kcne2 Kcnh2 Kcnj2 Kcnq1 Ryr2 And Scn5a |
| 81415-CPT | High | Exome (Eg Unexplaind Constituti Or Heritable Disord Or Syndro, Exome (Eg Unexplained Constitutional Or Heritable Disorder Or Syndrom |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81411. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81411 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 81411) and we'll show you how you compare in 15 minutes or less.