CPT 81459: Tumor Genomic Sequencing Panel for Solid Organ Cancers
Commercial payers pay $2433 on average nationally for this procedure.
CPT code 81459 describes a comprehensive genomic sequencing panel performed on a tumor specimen that evaluates DNA and RNA sequence variants, copy number variants, and rearrangements relevant to diagnosis and treatment of solid organ cancers and also assesses biomarkers such as microsatellite instability (MSI) and tumor mutation burden (TMB); this is a molecular pathology/genomic profiling service typically performed in a clinical laboratory and reported as a genomic sequence analysis panel for oncology care.
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 benchmarks for CPT 81459 center around BUCA’s average commercial rate of $2,433.30, with individual plans showing varied central tendency and dispersion. Blue Cross Blue Shield’s median sits near BUCA’s midpoint but its distribution is wide; Cigna and Aetna have relatively high medians and means, while UnitedHealth Group shows a lower median versus its mean, indicating some high outliers driving the average upward.
Assessing dispersion using the interquartile range (P75 minus P25) highlights differences in consistency: Blue Cross Blue Shield has the widest IQR at $1,442.60, followed by Cigna at $1,952.40 and BUCA at $1,485.30. The tightest spread is Aetna at $897.60, with UnitedHealth Group showing a moderate IQR of $1,733.90. These spreads reflect which payers have more concentrated commercial rates versus those with broader variability.