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See a sample rate comparisonCPT 81552 Fee Schedule
Last Verified: October 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 Uveal Mlnma Mrna 15 Gene, Oncology Uveal Melanoma Mrna Gene Expression Profiling By Real Time Rt Pcr Of 15 Genes 12 Content And 3 Housekeeping Utilizing Fine Needle Aspirate Or Formalin Fixed Paraffin Embedded Tissue Algorithm Reported As Risk Of Metastasis
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Multianalyte Assays with Algorithmic Analyses |
| Common Place of Service | 81 - Independent Laboratory |
| Complexity Level | High |
| Medicare Fee Schedule | $7,776.00 national lab fee schedule rate (2026) · View Medicare rates for 81552 |
| Medicaid Fee Schedule | $7,776.00 median of the 8 states in the free preview · View Medicaid rates for 81552 |
National average reimbursement for CPT 81552 by major payers:
$7,096.86
$4,748.53
$6,160.23
$11,264.06
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CPT 81552
5 of 25 sample ratesHigher to lower in this preview
Matthew Lilley
Bend Memorial Clinic, PC
$11,664.00Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$9,237.89Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$5,734.33Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$3,888.00Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$3,110.39Published rate
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See a sample payer proposalCPT 81552 vs. Other Multianalyte Assays with Algorithmic Analyses Codes
The CPT 81552 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 81552 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 |
|---|---|---|
| 81541-CPT | High | Oncology (Prostate) Mrna Gene, Oncology (Prostate) Mrna Gene Expression Profiling By Real-Time Rt-Pcr Of 46 Genes (31 Content And 15 Housekeeping) Utilizing Formalin-Fixed Paraffin-Embedded Tissue Algorithm Reported As A Disease-Specific Mortality Risk Score Hpa-9ab (V837m) |
| 81542-CPT | High | Onc Prostate Mrna 22 Cnt Gen, Oncology Prostate Mrna Microarray Gene Expression Profiling Of 22 Content Genes Utilizing Formalin Fixed Paraffin Embedded Tissue Algorithm Reported As Metastasis Risk Score |
| 81546-CPT | High | Onc Thyr Mrna 10 196 Gen Alg, Oncology Thyroid Mrna Gene Expression Analysis Of 10 196 Genes Utilizing Fine Needle Aspirate Algorithm Reported As A Categorical Result Eg Benign Or Suspicious |
| 81552-CPT | High | Onc Uveal Mlnma Mrna 15 Gene, Oncology Uveal Melanoma Mrna Gene Expression Profiling By Real Time Rt Pcr Of 15 Genes 12 Content And 3 Housekeeping Utilizing Fine Needle Aspirate Or Formalin Fixed Paraffin Embedded Tissue Algorithm Reported As Risk Of Metastasis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81552 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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