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See a sample rate comparisonCPT 81459 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.
So Neo Gsap Dna Dna Rna, Solid Organ Neoplasm Genomic Sequence Analysis Panel Interrogation For Sequence Variants Dna Analysis Or Combined Dna And Rna Analysis Copy Number Variants Microsatellite Instability Tumor Mutation Burden And Rearrangements
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Genomic Sequencing Procedures and Other Molecular Multianalyte Assays |
| Complexity Level | High |
| Medicare Fee Schedule | $2,989.55 national lab fee schedule rate (2026) · View Medicare rates for 81459 |
| Medicaid Fee Schedule | $2,636.79 median of the 8 states in the free preview · View Medicaid rates for 81459 |
National average reimbursement for CPT 81459 by major payers:
$2,797.50
$2,683.64
$675.90
$4,373.86
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CPT 81459
5 of 25 sample ratesHigher to lower in this preview
Reza Eshraghi
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$1,793.72Published rateLilia Correa
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$1,793.72Published rateCesar Lam
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$1,793.72Published rateAmber Vazquez
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$1,524.67Published rateTimothy Bondell
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$1,524.67Published rate
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See a sample payer proposalCPT 81459 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes
The CPT 81459 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 81459 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 |
|---|---|---|
| 81459-CPT | High | So Neo Gsap Dna Dna Rna, Solid Organ Neoplasm Genomic Sequence Analysis Panel Interrogation For Sequence Variants Dna Analysis Or Combined Dna And Rna Analysis Copy Number Variants Microsatellite Instability Tumor Mutation Burden And Rearrangements |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81459. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81459 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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