CPT 81479 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 81479 by major payers:

$435.28

$870.37

$95.22

$149.25
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 81479 | ||||||
United | 81479 | $1000000.00 | 1871734426 - IHC HEALTH SERVICES INC, SOUTHRIDGE CLINIC OB-GYN | 1871734426 - (UT) IHC HEALTH SERVICES INC | UT | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $1000000.00 | 1467588178 - IHC HEALTH SERVICES INC, INTERMOUNTAIN LEGACY OB/GYN | 1467588178 - (UT) IHC HEALTH SERVICES INC | UT | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $466.00 | 1487071502 - CAROLINE FRIEDMAN | 141725139 - PREMISE HEALTH OF NEW YORK MEDICAL PC | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $466.00 | 1265552897 - SARA KOSTANT | 141725139 - PREMISE HEALTH OF NEW YORK MEDICAL PC | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $1000000.00 | 1013045384 - IHC HEALTH SERVICES INC, BUDGE CLINIC OBSTETRICS AND GYNECOLOGY | 1013045384 - (UT) IHC HEALTH SERVICES INC | UT | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $1000000.00 | 1871734426 - IHC HEALTH SERVICES INC, SOUTHRIDGE CLINIC OB-GYN | 1871734426 - (UT) IHC HEALTH SERVICES INC | UT | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $1404.00 | 1912160763 - MARCOS SOSA | 746000203 | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $1000000.00 | 1013045384 - IHC HEALTH SERVICES INC, BUDGE CLINIC OBSTETRICS AND GYNECOLOGY | 1013045384 - (UT) IHC HEALTH SERVICES INC | UT | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $466.00 | 1265552897 - SARA KOSTANT | 141725139 - PREMISE HEALTH OF NEW YORK MEDICAL PC | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $1000000.00 | 1871734426 - IHC HEALTH SERVICES INC, SOUTHRIDGE CLINIC OB-GYN | 1871734426 - (UT) IHC HEALTH SERVICES INC | UT | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $1000000.00 | 1467588178 - IHC HEALTH SERVICES INC, INTERMOUNTAIN LEGACY OB/GYN | 1467588178 - (UT) IHC HEALTH SERVICES INC | UT | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $466.00 | 1487071502 - CAROLINE FRIEDMAN | 141725139 - HEALTHWORKS MED GROUP OF TEXAS DARLINGTON P A / MEDICAL OFFICES OF OCCUPATIONAL HEALTH RESOURCES P C / PREMISE HEALTH OF CALIFORNIA MEDICAL PC | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $1000000.00 | 1467588178 - IHC HEALTH SERVICES INC, INTERMOUNTAIN LEGACY OB/GYN | 1467588178 - (UT) IHC HEALTH SERVICES INC | UT | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $466.00 | 1265552897 - SARA KOSTANT | 141725139 - HEALTHWORKS MED GROUP OF TEXAS DARLINGTON P A / MEDICAL OFFICES OF OCCUPATIONAL HEALTH RESOURCES P C / PREMISE HEALTH OF CALIFORNIA MEDICAL PC | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 81479 | $466.00 | 1487071502 - CAROLINE FRIEDMAN | 141725139 - PREMISE HEALTH OF NEW YORK MEDICAL PC | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 81479 vs. Other Genomic Sequencing Procedures and Other Molecular Multianalyte Assays Codes
The CPT 81479 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 81479 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 |
|---|---|---|
| 81415-CPT | High | Exome (Eg, Unexplained Constitutional Or Heritable Disorder Or Syndrome); Sequence Analysis |
| 81416-CPT | High | Exome (Eg, Unexplained Constitutional Or Heritable Disorder Or Syndrome); Sequence Analysis, Each Comparator Exome (Eg, Parents, Siblings) (List Separately In Addition To Code For Primary Procedure) |
| 81418-CPT | Moderate | Drug Metabolism (Eg, Pharmacogenomics) Genomic Sequence Analysis Panel, Must Include Testing Of At Least 6 Genes, Including Cyp2c19, Cyp2d6, And Cyp2d6 Duplication/Deletion Analysis |
| 81479-CPT | Moderate | Lab Tests Other Nonmedicare Fee Schedule |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81479. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81479 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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