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See a sample rate comparisonCPT 81518 Fee Schedule
Last Verified: September 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.
Onc Brst Mrna 11 Genes, Oncology Breast Mrna Gene Expression Profiling By Real Time Rt Pcr Of 11 Genes 7 Content And 4 Housekeeping Utilizing Formalin Fixed Paraffin Embedded Tissue Algorithms Reported As Percentage Risk For Metastatic Recurrence And Likelihood Of Benefit From Extended Endocrine Therapy
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Multianalyte Assays with Algorithmic Analyses |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 81518 |
| Medicaid Fee Schedule | View Medicaid rates for 81518 |
National average reimbursement for CPT 81518 by major payers:
$2,924.66
$2,364.59
$3,514.63
$5,314.51
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CPT 81518
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$8,520.60Published rateAaron Askew
Praxis Health, P.C.
$4,260.30Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$2,856.11Published rateMatthew Lilley
The Orthopedic And Neurosurgical Center Of The Cascades
$1,626.66Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$1,355.55Published rate
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See a sample payer proposalCPT 81518 vs. Other Multianalyte Assays with Algorithmic Analyses Codes
The CPT 81518 code is part of the Pathology and Laboratory Procedures services used for Multianalyte Assays with Algorithmic Analyses. 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 81518 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 |
|---|---|---|
| 81518-CPT | High | Onc Brst Mrna 11 Genes, Oncology Breast Mrna Gene Expression Profiling By Real Time Rt Pcr Of 11 Genes 7 Content And 4 Housekeeping Utilizing Formalin Fixed Paraffin Embedded Tissue Algorithms Reported As Percentage Risk For Metastatic Recurrence And Likelihood Of Benefit From Extended Endocrine Therapy |
| 81519-CPT | High | Oncology (Breast) Mrna Gene, Oncology (Breast) Mrna Gene Expression Profilingby Real-Time Rt-Pcr Of 21 Genes Utilizing Formal In-Fixed Paraffin-Embedded Tissue Algorithm Reported As Recurrence Score |
| 81520-CPT | High | Oncology (Breast) Mrna Gene E, Oncology (Breast) Mrna Gene Expression Profiling By Hybrid Capture Of 58 Genes (50 Content And 8 Housekeeping) Utilizing Formalin-Fixed Paraffin-Embedded Tissue Algorithm Reported As A Recurrence Risk Score Hpa-9ab (V837m) |
| 81521-CPT | High | Oncology (Breast) Mrna Micro, Oncology (Breast) Mrna Microarray Gene Expression Profiling Of 70 Content Genes And 465 Housekeeping Genes Utilizing Fresh Frozen Or Formalin-Fixedparaffin-Embedded Tissue Algorithm Reported As I Ndex Related To Risk Of Distant Metastasis Hpa-9ab (V837m) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81518. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81518 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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