CPT 81451: Hematolymphoid RNA Sequence Panel, 5-50 Genes
CPT code 81451 represents a targeted genomic sequencing panel that analyzes RNA alterations in 5–50 genes associated with hematolymphoid cancers and disorders. This molecular pathology test supports diagnosis, prognosis, and treatment selection for patients with suspected or established blood and lymph malignancies. As genomic medicine expands, targeted RNA panels play a growing role in identifying actionable variants and informing precision oncology care pathways nationally.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of clinical context for RNA-based hematolymphoid testing, distinctions between related CPT codes for DNA and RNA panels, and the typical service and site-of-service considerations for laboratory-based genomic testing. The publication also outlines common billing modifiers and associated clinical taxonomies where available, and highlights how this code fits within molecular diagnostics workflows and reimbursement frameworks. The material is intended to provide clinicians, laboratory managers, and billing professionals with a concise reference to the clinical purpose of CPT code 81451, typical use cases, and how it relates to adjacent genomic panel codes.
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Billing Code Overview
CPT code 81451 describes a targeted genomic sequence analysis panel that evaluates a patient specimen for RNA alterations across five to 50 genes associated with hematolymphoid (blood or lymph) cancers or disorders. The procedure is a laboratory-based molecular diagnostic test in which a lab analyst performs genomic sequence analysis to detect clinically relevant RNA variants.
Service type: Molecular pathology / genomic sequencing panel
Typical site of service: Clinical laboratory or hospital laboratory, with specimen collection typically occurring in inpatient or outpatient clinical settings.
National Reimbursement Benchmarks
Commercial reimbursement for CPT 81451 clusters around BUCA’s average commercial rate of $711.40, with individual payers showing meaningful spread. Blue Cross Blue Shield peaks with a high mean and sizable upper tail, while Aetna and UnitedHealth Group sit lower on median values. Cigna’s mean and max suggest higher-cost outliers are present. Overall, the landscape is heterogeneous: some payers center near BUCA’s average while others extend substantially above it, indicating variable negotiated prices across commercial contracts.
Dispersion measured by the interquartile range (P75–P25) highlights which payers are tightest and widest. Aetna’s IQR is $135.00 ($630.00–$379.50), the tightest range, suggesting more concentrated pricing. Blue Cross Blue Shield’s IQR is $306.40 ($939.70–$563.30) and Cigna’s IQR is $521.90 ($917.40–$397.50), the widest, indicating broader variability; UnitedHealth Group’s IQR is $369.50 ($759.50–$319.00). BUCA’s quartiles span $210.00 ($854.30–$464.30).