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See a sample rate comparisonCPT 81596 Fee Schedule
Last Verified: October 2026
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.
Nfct Ds Chrnc Hcv 6 Assays, Infectious Disease Chronic Hepatitis C Virus Hcv Infection Six Biochemical Assays Alt A2 Macroglobulin Apolipoprotein A 1 Total Bilirubin Ggt And Haptoglobin Utilizing Serum Prognostic Algorithm Reported As Scores For Fibrosis And Necroinflammatory Activity In Liver
| 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 | 90 - Reference Laboratory TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $72.19 national lab fee schedule rate (2026) · View Medicare rates for 81596 |
| Medicaid Fee Schedule | $67.86 median of the 8 states in the free preview · View Medicaid rates for 81596 |
National average reimbursement for CPT 81596 by major payers:
$57.44
$44.26
$70.65
$121.12
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CPT 81596
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$158.82Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$95.29Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$72.19Published rateCatherine Lee
Columbus Arthritis Center
$43.31Published 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
$25.27Published rate
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See a sample payer proposalCPT 81596 vs. Other Multianalyte Assays with Algorithmic Analyses Codes
The CPT 81596 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 81596 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 |
|---|---|---|
| 81560-CPT | Moderate | Trnsplj Pd Lvr Bwl Cd154 Cll, Transplantation Medicine Allograft Rejection Pediatric Liver And Small Bowel Measurement Of Donor And Third Party Induced Cd154 T Cytotoxic Memory Cells Utilizing Whole Peripheral Blood Algorithm Reported As A Rejection Risk Score |
| 81595-CPT | High | Cardiology Hrt Trnspl Mrna, Cardiology Heart Transplant Mrna Gene Expression Profiling By Real Time Quantitative Pcr Of 20 Genes 11 Content And 9 Housekeeping Utilizing Subfraction Of Peripheral Blood Algorithm Reported As A Rejection Risk Score |
| 81596-CPT | Low | Nfct Ds Chrnc Hcv 6 Assays, Infectious Disease Chronic Hepatitis C Virus Hcv Infection Six Biochemical Assays Alt A2 Macroglobulin Apolipoprotein A 1 Total Bilirubin Ggt And Haptoglobin Utilizing Serum Prognostic Algorithm Reported As Scores For Fibrosis And Necroinflammatory Activity In Liver |
| 81599-CPT | Moderate | Multiple Lab Test Analysis, A Mathematic Formula Is Used To Analyze A Variety Of Lab Test Results To Determine An Individuals Risk For Disease. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 81596. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 81596 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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