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See a sample rate comparisonCPT 81418 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.
Rx Metab Gen Seq Alys Pnl 6, Drug Metabolism Eg Pharmacogenomics Genomic Sequence Analysis Panel Must Include Testing Of At Least 6 Genes Including Cyp2c19 Cyp2d6 And Cyp2d6 Duplication Deletion Analysis
| 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 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 81418 |
| Medicaid Fee Schedule | View Medicaid rates for 81418 |
National average reimbursement for CPT 81418 by major payers:
$811.37
$551.95
$804.49
$1,347.82
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CPT 81418
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$2,017.58Published rateJohn D. Archbold Memorial Hospital, Inc.
John D Archbold Memorial Hospital Inc
$917.08Published rateChristopher Raio
St Joseph Hospital
$550.25Published rateChristopher Raio
St Francis Hospital
$495.22Published rateAnant Desai
Renal Consultants Medical Group
$385.17Published rate
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See a sample payer proposalCPT 81418 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes
The CPT 81418 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 81418 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 |
|---|---|---|
| 81418-CPT | Moderate | Rx Metab Gen Seq Alys Pnl 6, Drug Metabolism Eg Pharmacogenomics Genomic Sequence Analysis Panel Must Include Testing Of At Least 6 Genes Including Cyp2c19 Cyp2d6 And Cyp2d6 Duplication Deletion Analysis |
| 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 |
| 81432-CPT | Moderate | Pathology Panel/Obstetric, Hereditary Breast Cancer-Related Disorders (Eg Hereditary Breast Cancer Hereditary Ovarian Cancer Hereditary Endometrial Cancer Hereditary Pancreatic Cancer Hereditary Prostate Cancer) Genomic Sequence Analysis Panel 5 Or More Genes Interrogation For Sequence Variants And Copy Number Variants; Genomic Sequence Analysis Panel Must Include Sequencing Of At Least 10 Genes Always Including Brca1 Brca2 Cdh1 Mlh1 Msh2 Msh6 Palb2 Pten Stk11 And Tp53 |
| 81439-CPT | Moderate | Hereditary Cardiomyopathy (Eg Hypertrophic Cardiomyopathy Dilated Cardiomyopathy Arrhythmogenic Right Ventricular Cardiomyopathy) Genomic Sequence Analysis Panel Must Include Sequencing Of At Least 5 Cardiomyopathy-Related Genes (Eg Dsg2 Mybpc3 Myh7 Pkp2 Ttn) (Desc Revised 1/1/2018) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81418. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81418 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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