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CPT 81432: Hereditary Breast Cancer Multi-Gene Sequencing Panel
CPT code 81432 represents a genomic sequencing panel that evaluates a patient specimen for genetic alterations in at least five genes associated with hereditary breast cancer disorders, including both sequence variants and copy number variants. Nationally, this code captures multi-gene molecular testing used in hereditary cancer assessment and has implications for diagnostic workflows, care pathways, and laboratory reporting standards.
Major national payers included in coverage analyses are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. The publication summarizes coverage trends and payer approaches to multi-gene hereditary breast cancer testing and situates CPT code 81432 within the broader set of molecular testing codes used for hereditary cancer evaluation.
Readers will learn the clinical scope of the service represented by CPT code 81432, typical laboratory and diagnostic contexts where the test is performed, and how this code relates to other molecular pathology codes used for BRCA and hereditary cancer testing. The report also provides benchmark considerations, policy and coding updates relevant to molecular diagnostic services, and a concise mapping to related molecular testing codes for clinical and billing reference.
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Billing Code Overview
CPT code 81432 describes a genomic sequence analysis panel performed by a laboratory analyst to evaluate a patient specimen for genetic sequences of at least five genes associated with hereditary breast cancer-related disorders. The analysis includes interrogation for both sequence variants and copy number variants, providing comprehensive molecular evaluation for inherited breast cancer risk.
Service type: Genomic sequence analysis panel for hereditary cancer genes
Typical site of service: Clinical molecular diagnostics laboratory
National Reimbursement Benchmarks
Commercial reimbursement for CPT 81432 centers around BUCA’s average commercial rate of $907.30, with notable variation among major payers. Blue Cross Blue Shield (BCBS) and Cigna show higher central tendencies ($1,131.70 mean for BCBS; $946.10 mean for Cigna) and wider upper tails, while Aetna and UnitedHealth Group present lower medians ($543 and $407.40, respectively) that pull their overall distributions downward compared with BUCA’s midpoint of $805.30.
Dispersion measured by the interquartile range (P75–P25) highlights differences in pricing consistency: Blue Cross Blue Shield’s IQR is $595.00, Cigna’s IQR is $1,193.10, BUCA’s IQR is $562.00, Aetna’s IQR is $371.00, and UnitedHealth Group’s IQR is $380.50. Cigna displays the widest spread, indicating the most variability in commercial rates, while Aetna has the tightest IQR, suggesting relatively more consistent negotiated rates.