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    v1.0.30
    OpenPayerBilling CodesGenomic Sequencing Procedures and Other Molecular Multianalyte AssaysCPT cpt-81413-genomic-panel-cardiac-ion-channelopathies
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    CPT 81413: Cardiac Ion Channelopathy Targeted Gene Panel

    Commercial payers pay $613 on average nationally for this procedure.

    CPT code 81413 describes a genomic sequencing panel service in which a laboratory analyst performs all technical steps to analyze DNA for genetic variants across a panel of at least 10 genes associated with cardiac ion channelopathies, a group of disorders affecting the heart’s electrical signaling; the service is a targeted genomic sequence analysis panel (DNA) typically performed in a clinical molecular genetics or pathology laboratory as an outpatient or reference lab test on patient specimens.

    For related coverage guidance, see recent payer policy updates: Oral Cancer Screening and Testing, RTM Testing for Alpha-1 Antitrypsin Deficiency, Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policy.

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    National Reimbursement Benchmarks

    Commercial rates for CPT 81413 cluster around BUCA’s average commercial benchmark of $613.30, with substantial variation among national payers. Blue Cross Blue Shield shows the highest dispersion and upper-end rates, with a broad spread between $472.70 (P25) and $776.20 (P75) and a max outlier at $2,346.10, while Cigna and UnitedHealth Group also present high ceilings of $2,654.00 and $2,165.30 respectively. Aetna’s central tendency is lower, with a mean of $417.90 and median of $456.20, sitting nearer BUCA’s midpoint than the highest-pay insurers.

    Measure of interquartile dispersion (P75 minus P25) highlights which payers are tightest or widest: Aetna’s range is $258.60, UnitedHealth Group’s is $318.30, BUCA’s is $382.20, Blue Cross Blue Shield’s is $289.50, and Cigna’s is $494.50. Cigna exhibits the widest IQR at $494.50, indicating the greatest mid-market variability, while Aetna is the tightest at $258.60, suggesting the most concentrated middle distribution among these commercial payers.

    National Payer Mean Reimbursement Rates

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    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 52-year-old patient with a family history of sudden cardiac death presents with palpitations and syncope. The cardiology team orders a hereditary cardiac arrhythmia panel to evaluate for cardiac ion channelopathies. A blood sample is collected in clinic and sent to an accredited molecular pathology laboratory. The laboratory accessioning staff logs the specimen; a molecular technologist extracts DNA and performs next-generation sequencing targeting the panel of genes (at least 10) implicated in ion channel disorders. A laboratory analyst performs the technical steps of the genomic sequence analysis, including library preparation, sequencing, primary data processing, and generation of variant calls. A molecular pathologist or laboratory director reviews technical quality metrics and signs out a clinical report indicating pathogenic, likely pathogenic, or variants of uncertain significance with interpretation tied to the patient’s clinical presentation. Results are routed back to the ordering cardiologist for correlation with ECG findings and family counseling. Billing for the technical component and molecular analysis uses 81413 for the genomic sequence analysis panel targeting cardiac ion channelopathy genes.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    81445Targeted genomic sequence analysis panel, solid organ neoplasm, DNA analysis, 5-50 genesMay be used for tumor-focused panels; related when targeted oncology panels are performed instead of or in addition to germline cardiac panels.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207ZP0102X
    207L00000X
    207RI0200X
    2085N0904X
    2278G1100X
    207QA0000X
    226300000X
    2081P0004X

    Related ICD-10-CM Codes

    33 rows

    ICD-10-CM CodeDescription
    C18.9Malignant neoplasm of colon, unspecified
    C25.9Malignant neoplasm of pancreas, unspecified
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C50.919Malignant neoplasm of unspecified site of unspecified female breast
    C61Malignant neoplasm of prostate
    D64.9Anemia, unspecified
    E03.9Hypothyroidism, unspecified
    E11.9Type 2 diabetes mellitus without complications
    E78.5Hyperlipidemia, unspecified
    F33.1Major depressive disorder, recurrent, moderate

    Showing 1–10 of 33

    Related Payer Policy Updates

    Specialty: Genetic & Molecular Testing1 / 3

    10 rows

    PolicyPayerEffective Date
    Oral Cancer Screening and TestingOscar Health2027-01-01
    RTM Testing for Alpha-1 Antitrypsin DeficiencyOscar Health2027-01-01
    Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policybcbsvermont2027-01-01
    Carrier Testing Panels for Genetic Diseases (for Kentucky Only)UnitedHealthcare2026-10-01
    Genetic Testing for Neurological Disorders (for Kansas Only)UnitedHealthcare2026-10-01
    Genetic and Molecular TestingProvidence Health Plan2026-10-01
    Cell-Free Fetal DNA Testing (for Idaho Only)UnitedHealthcare2026-10-01
    Next Generation Sequencing for Minimal Residual Disease DetectionProvidence Health Plan2026-10-01
    Pharmacogenetic Panel Testing (for Kansas Only)UnitedHealthcare2026-10-01
    Non-Covered Genetic Panel TestsProvidence Health Plan2026-10-01

    Related Codes

    CPT-81410-GENOMIC-PANEL-AORTIC-DISEASE

    CPT 81410: Heritable Thoracic Aortic Disease Targeted Gene Panel

    CPT-81411-GENETIC-DUPLICATION-DELETION-PANEL-AORTIC-DISEASE

    CPT 81411: Genetic Panel for Aortic Dysfunction Copy Number Analysis

    CPT-81412-ASHKENAZI-JEWISH-GENOMIC-SEQUENCE-PANEL

    CPT 81412: Ashkenazi Jewish–Associated Genetic Sequence Panel

    CPT-81414-CARDIAC-ION-CHANNELOPATHY-CNV-PANEL

    CPT 81414: Cardiac Ion Channelopathy Copy Number Variant Panel

    CPT-81415-EXOME-SEQUENCE-ANALYSIS-UNEXPLAINED-DISORDER

    CPT 81415: Exome Sequence Analysis for Unexplained Disorder

    CPT-81416-FAMILIAL-EXOME-SEQUENCE-ANALYSIS

    CPT 81416: Relative Exome Sequence Analysis for Reference Exome

    CPT-81417-EXOME-SEQUENCE-REEVALUATION

    CPT 81417: Exome Reanalysis for New Clinical Information

    CPT-81418-PHARMACOGENOMIC-MULTIGENE-DRUG-METABOLISM-PANEL

    CPT 81418: Pharmacogenetic Multigene Panel Including CYP2C19 and CYP2D6

    CPT-81419-GENOMIC-SEQUENCE-PANEL-EPILEPSY

    CPT 81419: Genomic Sequence Analysis Panel for Epilepsy

    CPT-81420-NIPS-FETAL-ANEUPLOIDY-SEQUENCING-PANEL

    CPT 81420: Cell-Free Fetal DNA Panel for Chromosomes 13, 18, 21

    Showing 1–10 of 43

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    88342 | Immunohistochemistry, per specimen; initial single antibody stain procedure | Used when immunohistochemical stains are performed on tissue specimens that accompany molecular testing in a diagnostic workup.

    88341 | Immunohistochemistry, per specimen; each additional single antibody stain procedure | Billed for additional IHC stains performed on the same specimen alongside molecular analysis.

    88360 | Morphometric analysis, tumor immunohistochemistry (e.g., HER-2/neu), quantitative or semiquantitative | Applied when quantitative IHC morphometry complements molecular testing in tumor characterization.