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See a sample rate comparisonCPT 81437 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.
Pathology Panel/Obstetric, Hereditary Neuroendocrine Tumor-Related Disorders (Eg Medullary Thyroid Carcinoma Parathyroid Carcinoma Malignant Pheochromocytoma Or Paraganglioma) 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 6 Genes Including Max Sdhb Sdhc Sdhd Tmem127 And Vhl
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 81437 |
| Medicaid Fee Schedule | View Medicaid rates for 81437 |
National average reimbursement for CPT 81437 by major payers:
$474.67
$315.02
$434.80
$845.82
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CPT 81437
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$965.65Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$444.01Published rateAaron Askew
Desert Bone & Joint Specialists, LLP
$252.88Published rateChristopher Raio
St Francis Hospital
$237.02Published 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
$153.63Published rate
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See a sample payer proposalCPT 81437 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes
The CPT 81437 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 81437 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 |
|---|---|---|
| 81437-CPT | Moderate | Pathology Panel/Obstetric, Hereditary Neuroendocrine Tumor-Related Disorders (Eg Medullary Thyroid Carcinoma Parathyroid Carcinoma Malignant Pheochromocytoma Or Paraganglioma) 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 6 Genes Including Max Sdhb Sdhc Sdhd Tmem127 And Vhl |
| 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) |
| 81440-CPT | High | Mitochondrial Gene, Nuclear Encoded Mitochondrial Genes Eg Neurologic Or Myopathic Phenotypes Genomic Sequence Panel Must Include Analysis Of At Least 100 Genes Including Bcs1l C10orf2 Coq2 Cox10 Dguok Mpv17 Opa1 Pdss2 Polg Polg2 Rrm2b Sco1 Sco2 Slc25a4 Sucla2 Suclg1 Taz Tk2 And Tymp |
| 81441-CPT | High | Ibmfs Seq Alys Pnl 30 Genes, Inherited Bone Marrow Failure Syndromes Ibmfs Eg Fanconi Anemia Dyskeratosis Congenita Diamond Blackfan Anemia Shwachman Diamond Syndrome Gata2 Deficiency Syndrome Congenital Amegakaryocytic Thrombocytopenia Sequence Analysis Panel Must Include Sequencing Of At Least 30 Genes Including Brca2 Brip1 Dkc1 Fanca Fancb Fancc Fancd2 Fance Fancf Fancg Fanci Fancl Gata1 Gata2 Mpl Nhp2 Nop10 Palb2 Rad51c Rpl11 Rpl35a Rpl5 Rps10 Rps19 Rps24 Rps26 Rps7 Sbds Tert And Tinf2 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81437. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81437 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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