CPT 81418: Pharmacogenetic Multigene Panel Including CYP2C19 and CYP2D6
Commercial payers pay $860 on average nationally for this procedure.
CPT code 81418 describes a pharmacogenetic multigene panel performed on blood or saliva to detect clinically relevant variants in six or more genes that affect drug metabolism; the test must include CYP2C19 and CYP2D6 variant analysis plus CYP2D6 duplication/deletion analysis and is used to inform medication selection and dosing. Service type: genetic testing / molecular pathology. Typical site of service: clinical laboratory or outpatient specimen collection.
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National Reimbursement Benchmarks
Commercial rates for CPT 81418 cluster around BUCA’s average commercial benchmark of $860.20, with notable variation across major payers. Blue Cross Blue Shield’s distribution skews higher with a median of $871.20 and a long tail to a max of $3,053.90, while Cigna and Aetna show elevated means of $852.50 and $605.20 respectively. UnitedHealth Group’s mean is lower at $729.20 and its median sits below BUCA’s average at $550.30. These contrasts indicate a market where BUCA sits near the center of commercial pricing but payers diverge meaningfully at the top end.
Dispersion measured by the interquartile range (P75–P25) highlights where rates are tightest and widest: Aetna’s IQR is $258.00, Cigna’s IQR is $648.10, Blue Cross Blue Shield’s IQR is $270.30, BUCA’s IQR is $375.00, and UnitedHealth Group’s IQR is $535.90. Cigna exhibits the widest IQR at $648.10, reflecting the greatest mid‑range variability, while Aetna is the tightest at $258.00, indicating more concentrated commercial reimbursement around its central range.