CPT 81443: Multi-Gene Genomic Sequence Analysis Panel (15+ Genes)
Commercial payers pay $2357 on average nationally for this procedure.
CPT code 81443 describes a genomic sequence analysis panel that evaluates a patient specimen for genetic sequences in a multi-gene panel (at least 15 genes) targeting severe inherited conditions, many enriched in individuals of Ashkenazi Jewish descent; service type: genomic diagnostic testing with laboratory-based sequence analysis; typical site of service: clinical diagnostic laboratory or hospital molecular pathology laboratory.
For related coverage guidance, see recent payer policy updates: RTM Testing of Homocysteine Metabolism-Related Conditions, Multimarker Serum Testing Related to Ovarian Cancer, Genomic Profiling for Selecting Targeted Cancer Therapies.
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National Reimbursement Benchmarks
National commercial reimbursement for CPT 81443 centers near BUCA’s average commercial rate of $2,356.60, with substantial variation among major payers. Blue Cross Blue Shield shows the highest dispersion between its 25th and 75th percentiles (range $1,275.00), and Cigna and UnitedHealth Group also display wide interquartile spreads ($1,757.20 and $1,469.20 respectively), signaling notable regional or contract-level variability. Aetna’s interquartile range is narrower at $1,003.70, representing one of the tighter distributions among these payers.
In absolute terms, payer-level medians and means diverge: Blue Cross Blue Shield and Cigna have higher mean and median benchmarks relative to Aetna and UnitedHealth Group, while BUCA’s mean at $2,356.60 sits between those groups. The IQR comparison highlights where reimbursement is more predictable (Aetna) versus where it is more dispersed (Blue Cross Blue Shield, Cigna, UnitedHealth Group).