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CPT 81458: Tumor Genomic Sequencing Panel with MSI
CPT code 81458 is a molecular pathology billing code for a comprehensive tumor genomic sequencing panel that identifies DNA sequence variants, copy number variants, and microsatellite instability (MSI) in solid organ cancers. This testing informs diagnosis, prognosis, and targeted treatment selection, making it central to precision oncology and cancer care nationally. Adoption of tumor genomic profiling has implications for treatment pathways, molecular tumor boards, and value-based cancer care programs.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise overview of clinical and billing context for CPT code 81458, including typical services rendered, usual laboratory site of service, and connections to related molecular oncology codes. The publication summarizes common payer coverage themes, benchmarking considerations, and clinical relevance for oncology and pathology stakeholders. It also highlights where data is available for utilization and reimbursement comparisons and notes related molecular testing codes for clinical cross-reference.
This executive summary is written for a national audience of providers, billing professionals, lab directors, and policy analysts seeking a clear understanding of the clinical role and billing identity of CPT code 81458.
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Billing Code Overview
CPT code 81458 represents a comprehensive genomic sequence analysis panel performed on a patient tumor specimen to detect DNA sequence variants and copy number variants that can impact diagnosis and treatment of solid organ cancers. The assay also evaluates microsatellite instability (MSI), a genomic feature that may influence tumor behavior and treatment selection.
Service type: Tumor genomic profiling / molecular oncology testing
Typical site of service: Clinical molecular pathology laboratory
National Reimbursement Benchmarks
National commercial pricing for CPT 81458 centers around BUCA’s average commercial rate of $881.50, which functions as a market midpoint. Among named payers, Blue Cross Blue Shield has the highest mean at $959.00 while Aetna and UnitedHealth Group have lower means of $687.00 and $832.50 respectively; Cigna’s mean sits near $892.70. Dispersion around the interquartile range varies materially: Blue Cross Blue Shield’s IQR is $484.00 ($1,185.90 − $690.10), and Cigna’s IQR is $725.10 ($1,214.70 − $528.90), indicating wider variability for those contracts compared with Aetna’s tighter IQR of $306.00 ($858.00 − $525.00). UnitedHealth Group’s IQR of $607.50 ($1,046.40 − $439.50) falls in between.
Looking at extremes, Blue Cross Blue Shield and Cigna exhibit the widest interquartile spreads, suggesting greater regional or product-level variation in allowed amounts, while Aetna demonstrates the narrowest spread and therefore more concentrated commercial pricing. BUCA’s mean provides a practical benchmark for market positioning at $881.50, and payer-specific IQR comparisons highlight where negotiated rates are most and least dispersed across commercial contracts.