CPT 81450: Targeted Genomic Panel for Hematolymphoid Neoplasms (5–50 Genes)
CPT code 81450 denotes a targeted genomic sequencing panel that analyzes DNA, and in some instances RNA, across five to 50 genes associated with hematolymphoid neoplasms. Nationally, this code represents an important molecular diagnostic service used in the evaluation and management of blood and lymph cancers, supporting precision diagnosis, prognostication, and therapy selection. Coverage and payment for this test influence access to advanced genomic diagnostics across clinical oncology and hematology practices.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and associated services, comparisons to closely related panels (including DNA-only and RNA-only panels), common sites of service, and payer coverage considerations. The publication highlights coding relationships and typical use cases in acute and chronic hematologic malignancies, as well as operational implications for laboratory billing and documentation.
This summary provides clinicians, laboratory managers, and revenue cycle professionals with a concise reference to the code’s clinical scope, how it fits alongside related genomic panels, and the payer landscape affecting adoption and reimbursement for hematolymphoid targeted sequencing panels.
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Billing Code Overview
CPT code 81450 describes a targeted genomic sequence analysis panel performed by a laboratory analyst to evaluate a patient specimen, such as blood or bone marrow, for DNA and possibly RNA alterations in five to 50 genes associated with hematolymphoid neoplasms (blood or lymph disorders and cancers). This test evaluates multiple gene targets to detect variants that inform diagnosis, prognosis, and potential therapeutic approaches.
Service type: Targeted genomic sequence analysis panel; molecular pathology/genomic testing
Typical site of service: Clinical laboratory or hospital-based molecular diagnostics laboratory; specimens commonly include blood or bone marrow
National Reimbursement Benchmarks
National commercial pricing for CPT 81450 centers around BUCA’s average commercial rate of $765.10, which serves as a useful mid-market reference. Blue Cross Blue Shield shows the highest dispersion between its 25th and 75th percentiles (range = $301.90), reflecting more variability in negotiated rates; Cigna and BUCA also display wide interquartile spreads ($704.40 and $368.50 respectively), while Aetna and UnitedHealth Group exhibit tighter distributions (Aetna range = $176.00; UnitedHealth Group range = $177.10). These ranges indicate meaningful differences in rate concentration across carriers rather than uniform pricing.
Examining central tendency, Cigna and Blue Cross Blue Shield have higher mean rates ($865.00 and $858.80) compared with Aetna and UnitedHealth Group (means of $527.30 and $528.50), with BUCA’s mean sitting at $765.10 between those groups. The largest absolute outliers in maximum values are with Blue Cross Blue Shield ($4,676.00) and Cigna ($2,899.70), suggesting occasional very high allowed amounts, whereas Aetna and UnitedHealth Group have much lower documented maxima.