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See a sample rate comparisonCPT 81470 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.
X Linked Intellectual Dblt, X Linked Intellectual Disability Xlid Eg Syndromic And Non Syndromic Xlid Genomic Sequence Analysis Panel Must Include Sequencing Of At Least 60 Genes Including Arx Atrx Cdkl5 Fgd1 Fmr1 Huwe1 Il1rapl Kdm5c L1cam Mecp2 Med12 Mid1 Ocrl Rps6ka3 And Slc16a2
| 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 | $914.00 national lab fee schedule rate (2026) · View Medicare rates for 81470 |
| Medicaid Fee Schedule | $868.295 median of the 8 states in the free preview · View Medicaid rates for 81470 |
National average reimbursement for CPT 81470 by major payers:
$714.37
$559.76
$899.11
$1,285.27
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CPT 81470
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$2,010.80Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$1,206.48Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$913.09Published rateSharron Acosta M.D.P.A.
Sharron Acosta, M.D., P.A.
$548.40Published rateAaron Askew
Desert Bone & Joint Specialists, LLP
$383.88Published rate
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See a sample payer proposalCPT 81470 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes
The CPT 81470 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 81470 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 |
|---|---|---|
| 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 |
| 81442-CPT | High | Noonan Spectrum Disorders, Noonan Spectrum Disorders Eg Noonan Syndrome Cardio Facio Cutaneous Syndrome Costello Syndrome Leopard Syndrome Noonan Like Syndrome Genomic Sequence Analysis Panel Must Include Sequencing Of At Least 12 Genes Including Braf Cbl Hras Kras Map2k1 Map2k2 Nras Ptpn11 Raf1 Rit1 Shoc2 And Sos1 |
| 81470-CPT | Moderate | X Linked Intellectual Dblt, X Linked Intellectual Disability Xlid Eg Syndromic And Non Syndromic Xlid Genomic Sequence Analysis Panel Must Include Sequencing Of At Least 60 Genes Including Arx Atrx Cdkl5 Fgd1 Fmr1 Huwe1 Il1rapl Kdm5c L1cam Mecp2 Med12 Mid1 Ocrl Rps6ka3 And Slc16a2 |
| 81471-CPT | Moderate | X Linked Intellectual Dblt, X Linked Intellectual Disability Xlid Eg Syndromic And Non Syndromic Xlid Duplication Deletion Gene Analysis Must Include Analysis Of At Least 60 Genes Including Arx Atrx Cdkl5 Fgd1 Fmr1 Huwe1 Il1rapl Kdm5c L1cam Mecp2 Med12 Mid1 Ocrl Rps6ka3 And Slc16a2 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81470. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81470 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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