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See a sample rate comparisonCPT 81456 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.
Targeted Genomic Sequence Analysis Panel, Solid Organ Or Hematolymphoid Neoplasm Or Disorder, 51 Or Greater Genes (Eg, Alk, Braf, Cdkn2a, Cebpa, Dnmt3a, Egfr, Erbb2, Ezh2, Flt3, Idh1, Idh2, Jak2, Kit, Kras, Met, Mll, Notch1, Npm1, Nras, Pdgfra, Pdgfrb, Pgr, Pik3ca, Pten, Ret), Interrogation For Sequence Variants And Copy Number Variants Or Rearrangements, Or Isoform Expression Or Mrna Expression Levels, If Performed; Rna 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 21 - Inpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | High |
| Medicare Fee Schedule | $2,919.60 national lab fee schedule rate (2026) · View Medicare rates for 81456 |
| Medicaid Fee Schedule | $2,890.405 median of the 8 states in the free preview · View Medicaid rates for 81456 |
National average reimbursement for CPT 81456 by major payers:
$2,498.96
$1,784.71
$2,633.03
$4,283.94
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CPT 81456
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$6,423.12Published rateChristopher Raio
Mercy Medical Center
$3,468.48Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$2,153.03Published rateCabrini Sutherland
Surgical Specialists Of Charlotte, PA
$1,459.80Published rateBaptist Health Care, Inc., Baptist Home Healt Care And Medical Equipment
Baptist Health Care Inc
$1,226.22Published rate
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See a sample payer proposalCPT 81456 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes
The CPT 81456 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 81456 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 |
|---|---|---|
| 81445-CPT | Moderate | Targeted Genomic Sequence Analysis Panel Solid Organ Neoplasm 5-50 Genes (Eg Alk Braf Cdkn2a Egfr Erbb2 Kit Kras Met Nras Pdgfra Pdgfrb Pgr Pik3ca Pten Ret) Interrogation For Sequence Variants And Copy Number Variants Or Rearrangements If Performed; Dna Analysis Or Combined Dna And Rna Analysis (Desc Rvsd 1/1/23) |
| 81449-CPT | Moderate | Tgsap So Neo 5 50 Rna Alys, Targeted Genomic Sequence Analysis Panel Solid Organ Neoplasm 5 50 Genes (Eg Alk Braf Cdkn2a Egfr Erbb2 Kit Kras Met Nras Pdgfra Pdgfrb Pgr Pik3ca Pten Ret) Interrogation For Sequence Variants And Copy Number Variants Or Rearrangements If Performed; Rna Analysis |
| 81450-CPT | Moderate | Targeted Genomic Sequence Analysis Panel Hematolymphoid Neoplasm Or Disorder 5-50 Genes (Eg Braf Cebpa Dnmt3a Ezh2 Flt3 Idh1 Idh2 Jak2 Kit Kras Mll Notch1 Npm1 Nras) Interrogation For Sequence Variants And Copy Number Variants Or Rearrangements Or Isoform Expression Or Mrna Expression Levels If Performed; Dna Analysis Or Combined Dna And Rna Analysis (Desc Rvsd 1/1/23) |
| 81456-CPT | High | Targeted Genomic Sequence Analysis Panel, Solid Organ Or Hematolymphoid Neoplasm Or Disorder, 51 Or Greater Genes (Eg, Alk, Braf, Cdkn2a, Cebpa, Dnmt3a, Egfr, Erbb2, Ezh2, Flt3, Idh1, Idh2, Jak2, Kit, Kras, Met, Mll, Notch1, Npm1, Nras, Pdgfra, Pdgfrb, Pgr, Pik3ca, Pten, Ret), Interrogation For Sequence Variants And Copy Number Variants Or Rearrangements, Or Isoform Expression Or Mrna Expression Levels, If Performed; Rna Analysis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81456. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81456 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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