CPT 81529 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Pathology and Laboratory Procedures • Multianalyte Assays with Algorithmic Analyses |
| Common Place of Service | • 81 - Independent Laboratory |
| Common Modifiers | • None • 59 - Distinct Procedural Service |
| Complexity Level | High |
National average reimbursement for CPT 81529 by major payers:
$5,827.53
$4,404.63
$6,508.51
$10,252.77
| 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 81529 | ||||||
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 81529 vs. Other Multianalyte Assays with Algorithmic Analyses Codes
The CPT 81529 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 81529 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 |
|---|---|---|
| 81525 | High | Oncology (Colon), Mrna, Gene Expression Profiling By Real-Time Rt-Pcr Of 12 Genes (7 Content And 5 Housekeeping), Utilizing Formalin-Fixed Paraffin-Embedded Tissue, Algorithm Reported As A Recurrence Score |
| 81528 | Moderate | Oncology (Colorectal) Screening Quantitative Real-Time Target And Signal Amplification Of 10 Dna Markers (Kras Mutations Promoter Methylation Of Ndrg4 And Bmp3) And Fecal Hemoglobin Utilizing Stool Algorithm Reported As A Positive Or Negative Result |
| 81529 | High | "Oncology (Cutaneous Melanoma), Mrna, Gene Expression Profiling By Real-Time Rt-Pcr Of 31 Genes (28 Content And 3 Housekeeping), Utilizing Formalin-Fixed Paraffin-Embedded Tissue, Algorithm Reported As Recurrence Risk, Including Likelihood Of Sentinel Lymph Node Metastasis" |
| 81535 | Moderate | Oncology (Gynecologic) Liver Tumor Cell Culture And Chemotherapeutic Response By Dapi Stain And Morphology Predictive Algorithm Reported As A Drug Response Score; First Single Drug Or Drug Combination. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81529. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81529 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 81529) and we'll show you how you compare in 15 minutes or less.
Medicare Reimbursement Lookup Tool
Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)
Select Year:
| Year | Billing Code | Locality | Non-Facility Fee | Facility Fee |
|---|