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See a sample rate comparisonCPT 81460 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.
Whole Mitochondrial Genome, Whole Mitochondrial Genome Eg Leigh Syndrome Mitochondrial Encephalomyopathy Lactic Acidosis And Stroke Like Episodes Melas Myoclonic Epilepsy With Ragged Red Fibers Merff Neuropathy Ataxia And Retinitis Pigmentosa Narp Leber Hereditary Optic Neuropathy Lhon Genomic Sequence Must Include Sequence Analysis Of Entire Mitochondrial Genome With Heteroplasmy Detection
| 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 | 90 - Reference Laboratory 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $1,287.00 national lab fee schedule rate (2026) · View Medicare rates for 81460 |
| Medicaid Fee Schedule | $1,287.00 median of the 8 states in the free preview · View Medicaid rates for 81460 |
National average reimbursement for CPT 81460 by major payers:
$945.12
$788.23
$1,259.72
$1,797.33
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CPT 81460
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$2,831.40Published rateChristopher Raio
St Francis Hospital
$1,285.71Published rateSharron Acosta M.D.P.A.
Sharron Acosta, M.D., P.A.
$772.20Published rateAaron Askew
Desert Bone & Joint Specialists, LLP
$540.54Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$514.79Published rate
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See a sample payer proposalCPT 81460 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes
The CPT 81460 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 81460 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) |
| 81460-CPT | Moderate | Whole Mitochondrial Genome, Whole Mitochondrial Genome Eg Leigh Syndrome Mitochondrial Encephalomyopathy Lactic Acidosis And Stroke Like Episodes Melas Myoclonic Epilepsy With Ragged Red Fibers Merff Neuropathy Ataxia And Retinitis Pigmentosa Narp Leber Hereditary Optic Neuropathy Lhon Genomic Sequence Must Include Sequence Analysis Of Entire Mitochondrial Genome With Heteroplasmy Detection |
| 81465-CPT | Moderate | Whole Mitochondrial Genome, Whole Mitochondrial Genome Large Deletion Analysis Panel Eg Kearns Sayre Syndrome Chronic Progressive External Ophthalmoplegia Including Heteroplasmy Detection If Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81460. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81460 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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