CPT 81457: Solid Organ Tumor Genomic Sequence Panel with MSI
Commercial payers pay $769 on average nationally for this procedure.
CPT code 81457 describes a laboratory genomic sequence analysis panel performed on a patient tumor specimen to detect DNA sequence variants that impact diagnosis and treatment of solid organ cancers and to evaluate microsatellite instability (MSI); this is a molecular pathology service typically performed by a clinical or anatomic pathology laboratory or molecular diagnostics lab and is commonly processed on specimens obtained in an outpatient or hospital-based pathology setting.
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
Commercial national average pricing for CPT 81457 centers around BUCA’s mean of $769, with notable variation among major payers. Blue Cross Blue Shield’s median is relatively high at $807.90 while Aetna’s median sits at $663.00; Cigna and UnitedHealth Group have medians near $803.60 and $538.10 respectively. These central tendencies position BUCA’s average close to several large commercial payers, indicating the overall market hovers in the mid-to-high hundreds for this code.
Dispersion measured by the interquartile range (P75 minus P25) highlights where pricing spreads are tightest and widest: Blue Cross Blue Shield’s IQR is $395.40 (P75 $1,016.50 minus P25 $627.10), Cigna’s IQR is $595.20 (P75 $1,044.20 minus P25 $458.80), Aetna’s IQR is $330.90 (P75 $735.40 minus P25 $430.50), UnitedHealth Group’s IQR is $523.20 (P75 $896.90 minus P25 $376.70), and BUCA’s IQR is $308.70 (P75 $954.30 minus P25 $524.60). BUCA therefore shows the tightest quartile spread and Cigna the widest, with Blue Cross Blue Shield and UnitedHealth Group in between.