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CPT 81427 Fee Schedule

Last Verified: January 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.

Genome (Eg Unexplained Constitutional Or Heritable Disorder Or Syndrome); Re-Evaluation Of Previously Obtained Genome Sequence (Eg Updated Knowledge Or Unrelated Condition/Syndrome)
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Genomic Sequencing Procedures and Other Molecular Multianalyte Assays

Common Modifiers

None

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 81427

National average reimbursement for CPT 81427 by major payers:

bcbs

$1,750.48

uhc

$1,431.61

aetna

$496.93

cigna

$3,391.54

Preview provider-level rates for...
For billing codeCPT 81427
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 81427

United
81427$1285.701851464549 - PROGRESSIVE MEDICAL CENTER SC363950044 - PROGRESSIVE MEDICAL CENTER, S.C.ILInternal Medicine Physician (207R00000X)
United
81427$1402.591497944565 - MICHAEL SHULER581076549 - ATHENS ORTHOPEDIC CLINIC, P.A.GAOrthopaedic Hand Surgery Physician (207XS0106X)
United
81427$3085.701255478004 - CHRISTOPHER RAIO208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PCNYEmergency Medicine Physician (207P00000X)
United
81427$935.051366400376 - SUNRISE HOME HEALTH CARE INC.650307774 - (FL) SUNRISE HOME HEALTH CARE INCFLHome Health Agency (251E00000X)
United
81427$851.231588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLCNYMulti-Specialty Group (193200000X)
United
81427$1262.331255478004 - CHRISTOPHER RAIO111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
81427$1168.831619910627 - BRADLEY WEISNER562107759 - UROLOGY SPECIALISTS OF THE CAROLINAS, PLLCNCUrology Physician (208800000X)
United
81427$981.811053866707 - BRITTANY PTACHICK541958039 - HROA 401K PLANVAFamily Nurse Practitioner (363LF0000X)
United
81427$1262.331255478004 - CHRISTOPHER RAIO112050523 - ST FRANCIS HOSPITALNYEmergency Medicine Physician (207P00000X)
United
81427$1262.331255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
81427$2335.311255478004 - CHRISTOPHER RAIO208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PCNYEmergency Medicine Physician (207P00000X)
United
81427$2337.651073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
81427$1285.701144370990 - ROLANDO HENRIQUEZ363950044 - PROGRESSIVE MEDICAL CENTER, S.C.ILInternal Medicine Physician (207R00000X)
United
81427$2777.131255478004 - CHRISTOPHER RAIO113438973 - ST JOSEPH HOSPITALNYEmergency Medicine Physician (207P00000X)
United
81427$3272.711255478004 - CHRISTOPHER RAIO111635088 - MERCY MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 81427 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes

The CPT 81427 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 81427 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.

CodeComplexityDescription
81417-CPTModerateExome (Eg, Unexplained Constitutional Or Heritable Disorder Or Syndrome); Re-Evaluation Of Previously Obtained Exome Sequence (Eg, Updated Knowledge Or Unrelated Condition/Syndrome)
81425-CPTHighGenome (Eg Unexplained Constitutional Or Heritable Disorder Or Syndrome); Sequence Analysis
81426-CPTHighGenome (Eg, Unexplained Constitutional Or Heritable Disorder Or Syndrome); Sequence Analysis, Each Comparator Genome (Eg, Parents, Siblings) (List Separately In Addition To Code For Primary Procedure)
81427-CPTHighGenome (Eg Unexplained Constitutional Or Heritable Disorder Or Syndrome); Re-Evaluation Of Previously Obtained Genome Sequence (Eg Updated Knowledge Or Unrelated Condition/Syndrome)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81427. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 81427 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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