CPT 81422: Cell‑free Fetal DNA Microdeletion Genomic Panel

Commercial payers pay $725 on average nationally for this procedure.

CPT code 81422 describes a genomic sequence analysis panel performed on circulating cell–free fetal DNA from maternal blood to evaluate for fetal chromosomal microdeletions (for example, DiGeorge or Cri–du–chat syndromes); this is a noninvasive prenatal testing service typically categorized as a genetic sequencing panel performed in a clinical laboratory or reference lab setting and ordered as part of prenatal screening or evaluation of suspected fetal chromosomal abnormalities.

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National Reimbursement Benchmarks

For CPT 81422 the average commercial benchmark is represented by BUCA at $724.70, with a median of $652.80 and interquartile spread from $472.90 to $879.10. Blue Cross Blue Shield (BCBS) shows the highest dispersion among listed payers: its P75 minus P25 equals $926.60 ($948.80 - $602.20), indicating wide variability in commercial contract rates. Cigna has the next-largest IQR at $660.90 ($1,035.90 - $387.50), while Aetna’s IQR is comparatively narrow at $389.00 ($633.00 - $324.40). UnitedHealth Group’s IQR is $371.30 ($759.10 - $318.80), the tightest among payers listed here.

Mean rates vary notably: BCBS’s mean is $827.10 and Cigna’s is $754.60, both above the BUCA average, while UnitedHealth Group’s mean is $610.90 and Aetna’s is $501.40, below BUCA. The combination of higher means and larger IQRs for BCBS and Cigna suggests more heterogeneous contracting or regional variation, whereas Aetna and UnitedHealth Group present more concentrated commercial rate distributions around their midpoints.

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CPT 81422: Cell‑free Fetal DNA Microdeletion Genomic Panel

Commercial payers pay $725 on average nationally for this procedure.

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Sign up for cpt 81422 policy alerts

Get alerted when payer policies referencing 81422 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 35-year-old pregnant patient presents for antenatal screening in the first or early second trimester with maternal age-related increased risk for fetal chromosomal abnormalities. The obstetrics clinic documents a routine prenatal visit citing Z36.0 (encounter for antenatal screening for chromosomal anomalies) and orders a noninvasive prenatal test (NIPT) that performs genomic sequence analysis of circulating cell–free fetal DNA to evaluate for chromosomal microdeletions (for example, DiGeorge syndrome or Cri–du–chat). A specimen (maternal blood) is collected in the outpatient phlebotomy area and sent to a reference molecular diagnostics laboratory. The laboratory performs CPT 81422 analysis, which includes extraction of cell‑free DNA, sequencing targeted regions associated with microdeletion syndromes, bioinformatic analysis, and generation of a report. Results are transmitted electronically to the ordering obstetrician or a genetic counselor (taxonomy 207SG0201X) who reviews positive or inconclusive findings with the patient, discusses confirmatory diagnostic options (such as chorionic villus sampling or amniocentesis), and coordinates follow-up care. Typical sites of service are outpatient obstetrics clinics, prenatal diagnostic centers, and reference molecular laboratories. This test is commonly ordered for patients with screening indications (Z36.0, Z13.79), abnormal ultrasound or family history raising suspicion (O35.1XX0), or advanced maternal age (O09.511, O09.521).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81420`	Fetal chromosomal aneuploidy genomic sequence analysis panel; circulating cell‑free fetal DNA	Related NIPT panel that focuses on common whole-chromosome aneuploidies (eg, trisomy 21, 18, 13); may be ordered instead of or alongside microdeletion panels depending on clinical indication.
`81436`	Hereditary colon cancer disorders duplication/deletion analysis panel	Not directly related to prenatal microdeletion testing; listed in input as a related molecular genetics panel but used for hereditary cancer evaluation in a different clinical context.

Related Modifiers

6 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…
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…
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…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
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…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207SG0201X	Clinical Genetics (M.D.) Physician	A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.
207SG0202X	Clinical Biochemical Genetics Physician	A clinical biochemical geneticist demonstrates competence in performing and interpreting biochemical analyses relevant to the diagnosis and management…
207VG0400X	Gynecology Physician	A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.
2471S1302X	Sonography Radiologic Technologist	A radiologic technologist who specializes in sonography and is appropriately educated and trained, consistent with nationally recognized standards, st…
2279P1006X	Pulmonary Function Technologist Registered Respiratory Therapist	An individual who is trained and qualified to perform pulmonary diagnostic tests. In the course of conducting these tests, the Pulmonary Function Tec…
225C00000X	Rehabilitation Counselor	An individual trained and educated in a systematic process of assisting persons with physical, mental, developmental, cognitive, and emotional disabil…
1744R1102X	Research Study Specialist	Other Service Providers · Specialist
172V00000X	Community Health Worker	Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care syste…

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

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-81413-GENOMIC-PANEL-CARDIAC-ION-CHANNELOPATHIES

CPT 81413: Cardiac Ion Channelopathy Targeted Gene 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

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 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
`81420`	Fetal chromosomal aneuploidy genomic sequence analysis panel; circulating cell‑free fetal DNA	Related NIPT panel that focuses on common whole-chromosome aneuploidies (eg, trisomy 21, 18, 13); may be ordered instead of or alongside microdeletion panels depending on clinical indication.
`81436`	Hereditary colon cancer disorders duplication/deletion analysis panel	Not directly related to prenatal microdeletion testing; listed in input as a related molecular genetics panel but used for hereditary cancer evaluation in a different clinical context.

Related Modifiers

6 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…
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…
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…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
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…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207SG0201X	Clinical Genetics (M.D.) Physician	A clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.
207SG0202X	Clinical Biochemical Genetics Physician	A clinical biochemical geneticist demonstrates competence in performing and interpreting biochemical analyses relevant to the diagnosis and management…
207VG0400X	Gynecology Physician	A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions.
2471S1302X	Sonography Radiologic Technologist	A radiologic technologist who specializes in sonography and is appropriately educated and trained, consistent with nationally recognized standards, st…
2279P1006X	Pulmonary Function Technologist Registered Respiratory Therapist	An individual who is trained and qualified to perform pulmonary diagnostic tests. In the course of conducting these tests, the Pulmonary Function Tec…
225C00000X	Rehabilitation Counselor	An individual trained and educated in a systematic process of assisting persons with physical, mental, developmental, cognitive, and emotional disabil…
1744R1102X	Research Study Specialist	Other Service Providers · Specialist
172V00000X	Community Health Worker	Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care syste…

Related Payer Policy Updates

Specialty: Genetic & Molecular Testing1 / 3

10 rows

Policy	Payer	Effective Date
RTM Testing of Homocysteine Metabolism-Related Conditions	Oscar Health	2026-10-01
Multimarker Serum Testing Related to Ovarian Cancer	Blue Cross Blue Shield - Rhode Island	2026-09-01
Genomic Profiling for Selecting Targeted Cancer Therapies	Blue Cross Blue Shield - Rhode Island	2026-09-01
Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders	Blue Cross Blue Shield - Rhode Island	2026-09-01
Biomarker and Genetic/Molecular Testing Coverage and Prior Authorization	Blue Cross Blue Shield - Rhode Island	2026-09-01
Non-Invasive Prenatal Testing (NIPT)	univerahealthcare	2026-08-17
Lumizyme (alglucosidase alfa) — Pompe Disease (acid alpha‑glucosidase deficiency)	Cigna	2026-08-15
Molecular Oncology Testing for Solid Tumor Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Molecular Oncology Testing for Hematologic Cancer Diagnosis, Prognosis, and Treatment Decisions	Colorado Rocky Mountain Health Plans	2026-08-01
Carrier Testing Panels for Genetic Diseases	Colorado Rocky Mountain Health Plans	2026-08-01

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-81413-GENOMIC-PANEL-CARDIAC-ION-CHANNELOPATHIES

CPT 81413: Cardiac Ion Channelopathy Targeted Gene 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

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 81422: Cell‑free Fetal DNA Microdeletion Genomic Panel

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National Reimbursement Benchmarks

CPT 81422: Cell‑free Fetal DNA Microdeletion Genomic Panel

Sign up for cpt 81422 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does CPT 81422 represent and when is it typically ordered?

Which ICD‑10 diagnosis codes are associated with ordering this microdeletion NIPT?

What is the typical specimen and laboratory workflow for this test?

Are there related CPT codes I should know about when ordering or billing for this test?

Where is this test usually performed and who reviews the results?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does CPT 81422 represent and when is it typically ordered?

Which ICD‑10 diagnosis codes are associated with ordering this microdeletion NIPT?

What is the typical specimen and laboratory workflow for this test?

Are there related CPT codes I should know about when ordering or billing for this test?

Where is this test usually performed and who reviews the results?

References