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See a sample rate comparisonCPT 81558 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.
Trnspl Rej Kdn Mrna Qpcr 139, Transplantation Medicine (Allograft Rejection Kidney) Mrna Gene Expression Profiling By Quantitative Polymerase Chain Reaction (Qpcr) Of 139 Genes Utilizing Whole Blood Algorithm Reported As A Binary Categorization As Transplant Excellence Which Indicates Immune Quiescence Or Not Transplant Excellence Indicating Subclinical Rejection
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Multianalyte Assays with Algorithmic Analyses |
| Complexity Level | High |
| Medicare Fee Schedule | $3,240.00 national lab fee schedule rate (2026) · View Medicare rates for 81558 |
| Medicaid Fee Schedule | $3,045.60 median of the 8 states in the free preview · View Medicaid rates for 81558 |
National average reimbursement for CPT 81558 by major payers:
$2,745.37
$2,908.47
$6,182.74
$3,301.30
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CPT 81558
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$7,892.95Published rateTift Regional Health System Inc., Tift Regional Medical Center
Tift Regional Health System Inc
$2,916.00Published rateLeigh Taylor
$1,944.00Published rateThe Hospital Authority Of Miller County, Miller County Hospital - Pro Fees
The Hospital Authority Of Miller County
$1,555.19Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$1,360.80Published rate
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See a sample payer proposalCPT 81558 vs. Other Multianalyte Assays with Algorithmic Analyses Codes
The CPT 81558 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 81558 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 |
|---|---|---|
| 81558-CPT | High | Trnspl Rej Kdn Mrna Qpcr 139, Transplantation Medicine (Allograft Rejection Kidney) Mrna Gene Expression Profiling By Quantitative Polymerase Chain Reaction (Qpcr) Of 139 Genes Utilizing Whole Blood Algorithm Reported As A Binary Categorization As Transplant Excellence Which Indicates Immune Quiescence Or Not Transplant Excellence Indicating Subclinical Rejection |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81558. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81558 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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