CPT 81430: Genomic Sequencing Panel for Hearing Loss (≥60 Genes)
Commercial payers pay $1617 on average nationally for this procedure.
CPT code 81430 describes a genomic sequencing panel service that analyzes a patient specimen for genetic variants across at least 60 genes, including 16 genes specifically associated with hearing loss; this is a genomic sequencing procedure typically performed as a molecular diagnostic panel using laboratory sequencing technologies and reported for specimens collected in clinical laboratory or specialized genetic testing facilities.
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National Reimbursement Benchmarks
The national commercial landscape for CPT 81430 centers around BUCA’s average commercial benchmark of $1,617.50, with individual payers showing meaningful variation around that midpoint. Blue Cross Blue Shield (BCBS) and Cigna sit above BUCA’s mean with medians of $1,589.40 and $1,456.00 respectively, while UnitedHealth Group’s median of $975.00 and Aetna’s median of $1,130.00 lie below. Maximums and minimums vary widely by carrier, contributing to a skew in some distributions and indicating pockets of higher contracted rates for this code.
Dispersion measured as the interquartile range (P75 minus P25) highlights where rates are tight or wide: Aetna’s IQR is $600.90, UnitedHealth Group’s IQR is $942.50, Cigna’s IQR is $1,290.80, BUCA’s IQR is $747.50, and BCBS’s IQR is $605.10. Cigna exhibits the widest middle 50% spread at $1,290.80, signaling the greatest variability among common commercial agreements, while Aetna and Blue Cross Blue Shield are the tightest at $600.90 and $605.10 respectively.