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See a sample rate comparisonCPT 81427 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.
Genome (Eg Unexplained Consti, Genome (Eg Unexplained Constitutional Or Heritable Disorder Or Syndrome) Re-Evaluation Of Previously Obtained Genome Sequence (Eg Updated Knowledgeor Unrelated Conditionsyndrome)
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Genomic Sequencing Procedures and Other Molecular Multianalyte Assays |
| Common Modifiers | None |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 81427 |
| Medicaid Fee Schedule | View Medicaid rates for 81427 |
National average reimbursement for CPT 81427 by major payers:
$1,750.48
$1,431.61
$496.93
$3,391.54
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CPT 81427
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$5,142.83Published rateChristopher Raio
St Joseph Hospital
$2,777.13Published rateMichael Shuler
Athens Orthopedic Clinic, P.A.
$1,402.59Published rateChristopher Raio
St Joseph Hospital
$1,262.33Published rateProgressive Emergency Physicians PLLC
$851.23Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 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) |
| 81425-CPT | High | Genom (Eg Unexplaind Constituti Or Heritable Disord Or Syndro, Genome (Eg Unexplained Constitutional Or Heritable Disorder Or Syndro |
| 81426-CPT | High | Genome (Eg Unexplained Consti, Genome (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-CPT | High | Genome (Eg Unexplained Consti, Genome (Eg Unexplained Constitutional Or Heritable Disorder Or Syndrome) Re-Evaluation Of Previously Obtained Genome Sequence (Eg Updated Knowledgeor Unrelated Conditionsyndrome) |
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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