CPT 81439: Hereditary Cardiomyopathy Multigene Sequence Panel

Commercial payers pay $619 on average nationally for this procedure.

CPT code 81439 describes a genomic sequence analysis panel performed by a laboratory analyst to evaluate a patient specimen for nucleotide sequence variants across at least five cardiomyopathy-related genes, used to assess hereditary cardiomyopathies such as hypertrophic, dilated, or arrhythmogenic right ventricular cardiomyopathy; service type: genetic diagnostic testing / multi-gene sequencing panel; typical site of service: clinical laboratory or reference molecular diagnostics lab.

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National Reimbursement Benchmarks

For CPT 81439, the commercial market centers around the BUCA average commercial rate of $619.30, with notable variation among major payers. Blue Cross Blue Shield displays the largest spread between its 75th and 25th percentiles at $328.00 ($775.70 - $468.70), followed by Cigna with a spread of $495.70 ($853.40 - $358.70). Aetna shows a more moderate dispersion of $293.10 ($526.40 - $267.30), while UnitedHealth Group is relatively tighter at $322.70 ($584.90 - $256.20). These interquartile spreads highlight meaningful payer-level differences in negotiated commercial pricing.

Looking at central tendency, Cigna and Blue Cross Blue Shield have higher mean rates at $737.00 and $686.20 respectively, while UnitedHealth Group’s mean sits lower at $502.90 and Aetna’s mean is $417.50. BUCA’s mean of $619.30 aligns between those payers, emphasizing BUCA as a mid-to-upper market benchmark. Presence of high maximums (e.g., Cigna $2,885.60; BCBS $2,346.10) further underscores upper-tail variability across commercial contracts.

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CPT 81439: Hereditary Cardiomyopathy Multigene Sequence Panel

Commercial payers pay $619 on average nationally for this procedure.

Customize your policy alerts

Sign up for cpt 81439 policy alerts

Get alerted when payer policies referencing 81439 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 42-year-old patient with a family history of sudden cardiac death and progressive exertional dyspnea presents to a cardiology clinic after echocardiography shows left ventricular hypertrophy and preserved ejection fraction. The cardiologist documents suspected hereditary hypertrophic cardiomyopathy and orders a multi-gene cardiomyopathy panel to evaluate pathogenic variants across at least five cardiomyopathy-related genes. The specimen (peripheral blood) is collected in the outpatient clinic and sent to a reference molecular laboratory. The laboratory performs genomic sequence analysis using next-generation sequencing and bioinformatic interpretation to detect single nucleotide variants, small insertions/deletions, and other sequence-level alterations in genes associated with hypertrophic, dilated, and arrhythmogenic cardiomyopathies. Results, including variant classification and clinical interpretation, are returned to the ordering provider. Typical sites of service include an outpatient cardiology clinic, an independent diagnostic laboratory, or an academic medical center molecular diagnostics laboratory. Billing uses the molecular pathology panel code 81439 with appropriate modifiers for professional or technical components as needed. Typical patient indications align with ICD-10 diagnoses such as I42.1, I42.2, I42.0, I42.8, or I42.9 when hereditary cardiomyopathy is suspected or being evaluated for familial risk assessment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`81440`	Hereditary cardiomyopathy gene panel analysis, Noonan spectrum disorders	Alternative or supplementary panel used when Noonan-spectrum clinical features suggest overlapping genetic causes; may be ordered instead of or in addition to `81439` depending on phenotype.
`81441`	Inherited bone marrow failure syndrome gene panel (at least 30 genes)	Not directly related to cardiomyopathy panels; listed as a related multi-gene panel code that illustrates differing gene-count thresholds and test scope.
`81448`	Hereditary peripheral neuropathy gene panel (at least five genes)	Another example of a multi-gene panel with a five-gene minimum; related by methodology and billing structure but used for peripheral neuropathy indications.

Related Modifiers

10 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…
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…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
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…

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.
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
261QS1000X	Student Health Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
103TH0100X	Health Service Psychologist	A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, …
163WM0102X	Maternal Newborn Registered Nurse	Nursing Service Providers · Registered Nurse
251K00000X	Public Health or Welfare Agency	Agencies · Public Health or Welfare
2084D0003X	Diagnostic Neuroimaging (Psychiatry & Neurology) Physician	A licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards…

Related ICD-10-CM Codes

5 rows

ICD-10-CM Code	Description
I42.0	Dilated cardiomyopathy
I42.1	Obstructive hypertrophic cardiomyopathy
I42.2	Other hypertrophic cardiomyopathy
I42.8	Other cardiomyopathies
I42.9	Cardiomyopathy, unspecified

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.

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
`81440`	Hereditary cardiomyopathy gene panel analysis, Noonan spectrum disorders	Alternative or supplementary panel used when Noonan-spectrum clinical features suggest overlapping genetic causes; may be ordered instead of or in addition to `81439` depending on phenotype.
`81441`	Inherited bone marrow failure syndrome gene panel (at least 30 genes)	Not directly related to cardiomyopathy panels; listed as a related multi-gene panel code that illustrates differing gene-count thresholds and test scope.
`81448`	Hereditary peripheral neuropathy gene panel (at least five genes)	Another example of a multi-gene panel with a five-gene minimum; related by methodology and billing structure but used for peripheral neuropathy indications.

Related Modifiers

10 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…
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…
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
23	Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…	- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
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…

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.
207Q00000X	Family Medicine Physician	Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
207R00000X	Internal Medicine Physician	A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
261QS1000X	Student Health Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center
103TH0100X	Health Service Psychologist	A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, …
163WM0102X	Maternal Newborn Registered Nurse	Nursing Service Providers · Registered Nurse
251K00000X	Public Health or Welfare Agency	Agencies · Public Health or Welfare
2084D0003X	Diagnostic Neuroimaging (Psychiatry & Neurology) Physician	A licensed physician, who has completed a residency program in Neurology, and who has additional training, experience, and competence in the standards…

Related ICD-10-CM Codes

5 rows

ICD-10-CM Code	Description
I42.0	Dilated cardiomyopathy
I42.1	Obstructive hypertrophic cardiomyopathy
I42.2	Other hypertrophic cardiomyopathy
I42.8	Other cardiomyopathies
I42.9	Cardiomyopathy, unspecified

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 81439: Hereditary Cardiomyopathy Multigene Sequence Panel

Sign up for cpt 81439 policy alerts

National Reimbursement Benchmarks

CPT 81439: Hereditary Cardiomyopathy Multigene Sequence Panel

Sign up for cpt 81439 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What clinical purpose does CPT 81439 serve?

Where is the 81439 panel usually performed and how is the specimen collected?

Which billing modifiers are commonly used with CPT 81439?

What does the reimbursement benchmark data show for CPT 81439 among major payers?

Which related CPT and ICD‑10 codes are referenced alongside 81439 and how are they relevant?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What clinical purpose does CPT 81439 serve?

Where is the 81439 panel usually performed and how is the specimen collected?

Which billing modifiers are commonly used with CPT 81439?

What does the reimbursement benchmark data show for CPT 81439 among major payers?

Which related CPT and ICD‑10 codes are referenced alongside 81439 and how are they relevant?

References