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.

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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.

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CPT 81413: Cardiac Ion Channelopathy Targeted Gene Panel

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

Customize your policy alerts

Sign up for cpt 81413 policy alerts

Get alerted when payer policies referencing 81413 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

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

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.

Related Modifiers

9 rows

Modifier	Description	When to Use
26	Modifier 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…
90	Modifier ‑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…
59	Modifier 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…
62	Modifier 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…
82	Modifier 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…
52	Modifier ‑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…
53	Modifier 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…
76	Modifier -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…
77	Modifier 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	Specialty	Notes
207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the labora…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
207RI0200X	Infectious Disease Physician	An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this…
2085N0904X	Nuclear Radiology Physician	A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the admi…
2278G1100X	General Care Certified Respiratory Therapist	This level of care includes diagnostics testing, therapeutics, monitoring, rehabilitation of patients with disorders of the cardiopulmonary system, as…
207QA0000X	Adolescent Medicine (Family Medicine) Physician	A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their …
226300000X	Kinesiotherapist	A provider trained and educated in the applied science of medically prescribed therapeutic exercise, education and adapted physical activities designe…
2081P0004X	Spinal Cord Injury Medicine Physician	A physician who addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic etiologies of spinal c…

Related ICD-10-CM Codes

33 rows

ICD-10-CM Code	Description
C18.9	Malignant neoplasm of colon, unspecified
C25.9	Malignant neoplasm of pancreas, unspecified
C34.90	Malignant neoplasm of unspecified part of unspecified bronchus or lung
C50.919	Malignant neoplasm of unspecified site of unspecified female breast
C61	Malignant neoplasm of prostate
D64.9	Anemia, unspecified
E03.9	Hypothyroidism, unspecified
E11.9	Type 2 diabetes mellitus without complications
E78.5	Hyperlipidemia, unspecified
F33.1	Major depressive disorder, recurrent, moderate

Showing 1–10 of 33

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.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.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.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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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

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

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

Related Modifiers

9 rows

Modifier	Description	When to Use
26	Modifier 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…
90	Modifier ‑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…
59	Modifier 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…
62	Modifier 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…
82	Modifier 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…
52	Modifier ‑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…
53	Modifier 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…
76	Modifier -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…
77	Modifier 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	Specialty	Notes
207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the labora…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
207RI0200X	Infectious Disease Physician	An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this…
2085N0904X	Nuclear Radiology Physician	A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the admi…
2278G1100X	General Care Certified Respiratory Therapist	This level of care includes diagnostics testing, therapeutics, monitoring, rehabilitation of patients with disorders of the cardiopulmonary system, as…
207QA0000X	Adolescent Medicine (Family Medicine) Physician	A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their …
226300000X	Kinesiotherapist	A provider trained and educated in the applied science of medically prescribed therapeutic exercise, education and adapted physical activities designe…
2081P0004X	Spinal Cord Injury Medicine Physician	A physician who addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic etiologies of spinal c…

Related ICD-10-CM Codes

33 rows

ICD-10-CM Code	Description
C18.9	Malignant neoplasm of colon, unspecified
C25.9	Malignant neoplasm of pancreas, unspecified
C34.90	Malignant neoplasm of unspecified part of unspecified bronchus or lung
C50.919	Malignant neoplasm of unspecified site of unspecified female breast
C61	Malignant neoplasm of prostate
D64.9	Anemia, unspecified
E03.9	Hypothyroidism, unspecified
E11.9	Type 2 diabetes mellitus without complications
E78.5	Hyperlipidemia, unspecified
F33.1	Major depressive disorder, recurrent, moderate

Showing 1–10 of 33

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.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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

CPT 81413: Cardiac Ion Channelopathy Targeted Gene Panel

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National Reimbursement Benchmarks

CPT 81413: Cardiac Ion Channelopathy Targeted Gene Panel

Sign up for cpt 81413 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What clinical service does CPT 81413 represent and where is it typically performed?

Which modifiers are applicable to CPT 81413 and when should they be used?

What do the market benchmarks indicate about payer reimbursement variability for CPT 81413?

Which related CPT codes might appear alongside or instead of CPT 81413 in laboratory workflows?

What is the typical clinical context and laboratory workflow for using CPT 81413?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Codes

What clinical service does CPT 81413 represent and where is it typically performed?

Which modifiers are applicable to CPT 81413 and when should they be used?

What do the market benchmarks indicate about payer reimbursement variability for CPT 81413?

Which related CPT codes might appear alongside or instead of CPT 81413 in laboratory workflows?

What is the typical clinical context and laboratory workflow for using CPT 81413?

References