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See a sample rate comparisonCPT 81413 Fee Schedule
Last Verified: October 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Genomic Sequencing Procedures and Other Molecular Multianalyte Assays |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 90 - Reference Laboratory 52 - Reduced Services |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 81413 |
| Medicaid Fee Schedule | View Medicaid rates for 81413 |
National average reimbursement for CPT 81413 by major payers:
$544.38
$420.51
$609.19
$844.37
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CPT 81413
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$1,286.78Published rateAsya Segalene
Allergy & Asthma Of Dupage, S.C.
$796.75Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$584.90Published rateAaron Askew
Desert Bone & Joint Specialists, LLP
$336.98Published 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
$204.72Published rate
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See a sample payer proposalCPT 81413 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes
The CPT 81413 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 81413 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 |
|---|---|---|
| 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 |
| 81414-CPT | Moderate | Car Ion Chnnlpath Inc 2 Gns, Cardiac Ion Channelopathies Eg Brugada Syndrome Long Qt Syndrome Short Qt Syndrome Catecholaminergic Polymorphic Ventricular Tachycardia Duplication Deletion Gene Analysis Panel Must Include Analysis Of At Least 2 Genes Including Kcnh2 And Kcnq1 |
| 81417-CPT | Moderate | Exome (Eg Unexplained Constit, Exome (Eg Unexplained Constitutional Or Heritabledisorder Or Syndrome) Re-Evaluation Of Previousl Y Obtained Exome Sequence (Eg Updated Knowledge Or Unrelated Conditionsyndrome) |
| 81419-CPT | High | Epilepsy Gen Seq Alys Panel, Epilepsy Genomic Sequence Analysis Panel Must Include Analyses For Aldh7a1 Cacna1a Cdkl5 Chd2 Gabrg2 Grin2a Kcnq2 Mecp2 Pcdh19 Polg Prrt2 Scn1a Scn1b Scn2a Scn8a Slc2a1 Slc9a6 Stxbp1 Syngap1 Tcf4 Tpp1 Tsc1 Tsc2 And Zeb2 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81413. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81413 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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