2026 CPT Code Reference
[ CMS & Medicare Verified ]| CPT Code | Description | Genes | Avg. Reimbursement | Category |
|---|---|---|---|---|
| 81432 | Hereditary breast cancer-related disorders (e.g., BRCA1, BRCA2) — full gene sequence analysis | 2 | $2,100 – $2,800 | Hereditary Cancer |
| 81433 | Hereditary breast cancer-related disorders — duplication/deletion analysis | 2 | $850 – $1,200 | Hereditary Cancer |
| 81445 | Targeted genomic sequence analysis panel, solid organ neoplasm, DNA analysis — 5-50 genes | 50 | $1,400 – $2,200 | Hereditary Cancer |
| 81450 | Targeted genomic sequence analysis panel, hematolymphoid neoplasm — 5-50 genes | 50 | $1,400 – $2,200 | Hereditary Cancer |
| 81455 | Targeted genomic sequence analysis panel, solid organ or hematolymphoid neoplasm — >50 genes | 108 | $2,800 – $4,500 | Hereditary Cancer |
| 81479 | Unlisted molecular pathology procedure — custom panels, novel biomarkers, and research assays | 230 | Varies — submit for review | Pharmacogenomics |
| 81225 | CYP2C19 gene analysis — common variants (e.g., *2, *3, *17) for clopidogrel & PPI metabolism | 1 | $180 – $260 | Pharmacogenomics |
| 81226 | CYP2D6 gene analysis — common variants (*3-*6, *9, *10, *17, *41) for antidepressant & tamoxifen metabolism | 1 | $180 – $260 | Pharmacogenomics |
| 81227 | CYP2C9 gene analysis — common variants (*2, *3) for warfarin & NSAID sensitivity | 1 | $180 – $260 | Pharmacogenomics |
| 81230 | CYP3A4 gene analysis — common variant (*22) for statin & immunosuppressant metabolism | 1 | $160 – $240 | Pharmacogenomics |
| 81231 | CYP3A5 gene analysis — common variants (*3, *6, *7) for tacrolimus & chemotherapy metabolism | 1 | $160 – $240 | Pharmacogenomics |
| 81350 | SLCO1B1 gene analysis — common variant (*5) for simvastatin-induced myopathy risk | 1 | $160 – $240 | Pharmacogenomics |
| 81400 | Molecular pathology procedure, Level 1 — single analyte (e.g., VKORC1, F5, F2, MTHFR) | 1 | $120 – $180 | Pharmacogenomics |
| 81401 | Molecular pathology procedure, Level 2 — single analyte with common variants (e.g., HLA-B*57:01, TPMT, DPYD) | 1 | $140 – $200 | Pharmacogenomics |
| 81408 | Molecular pathology procedure, Level 9 — full gene sequence analysis (e.g., CFTR, DMD, HBA1/HBA2) | 1 | $900 – $1,400 | Comprehensive |
| 81442 | Noonan spectrum disorders gene analysis panel — 5-50 genes (PTPN11, SOS1, RAF1, KRAS, NRAS, BRAF, MAP2K1, SHOC2, CBL) | 9 | $1,200 – $1,800 | Pediatric / Inherited |
| 81443 | Genetic testing for severe inherited conditions (e.g., SMA, CF) — carrier screening panel | 3 | $600 – $950 | Pediatric / Inherited |
| 81228 | CYP2C19 gene analysis — full sequence (all exons) for rare variant detection | 1 | $450 – $650 | Pharmacogenomics |
| 81435 | Hereditary colon cancer disorders (e.g., Lynch syndrome) — 5-50 genes including MLH1, MSH2, MSH6, PMS2, EPCAM | 5 | $1,400 – $2,000 | Hereditary Cancer |
| 81437 | Hereditary colon cancer disorders — duplication/deletion analysis for Lynch syndrome genes | 5 | $700 – $1,100 | Hereditary Cancer |
Reimbursement rates are estimates based on 2026 Medicare fee schedules and may vary by payer, region, and patient coverage. Always verify with your billing department.
How We Help You Bill
Handled Before You Order
Our billing team verifies coverage and completes prior-authorization paperwork with payers before the test is run — no surprise denials for your practice.
Complete Documentation
Every order ships with a payer-ready superbill: CPT codes, ICD-10 crosswalk, ordering physician NPI, and CLIA laboratory identifiers included.
Medical Necessity Mapping
Each panel maps to accepted ICD-10 indication codes, so medical-necessity documentation is consistent across Medicare and commercial payers.
CMS · Medicare · Commercial
Codes and rates on this page are pre-verified against CMS, Medicare, and commercial payer fee schedules for 2026 and updated as schedules change.
Need a code that isn’t listed? Our provider team responds within one business day — contact us.
Bill With Confidence
Join 5,000+ provider partners ordering CLIA-certified genetic testing with pre-authorization support, superbills, and a dedicated billing team behind every order.