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CPT 81462: Liquid Biopsy Genomic Sequencing Panel for Solid Tumors
CPT code 81462 describes a comprehensive liquid biopsy genomic sequencing panel performed on plasma to identify cell–free DNA or DNA/RNA alterations relevant to solid organ cancers. The test detects sequence variants, copy number changes, and rearrangements that inform diagnosis, prognosis, and targeted therapy selection. Nationally, plasma-based genomic testing has grown as a minimally invasive option when tissue biopsies are infeasible or to monitor tumor heterogeneity and treatment resistance.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of payer coverage patterns, coding relationships to related molecular pathology codes, and clinical context for use of plasma cfDNA panels. The publication also outlines common billing modifiers and related taxonomy specialties used by ordering and performing providers.
This summary provides clinicians, coding professionals, and policy analysts with benchmarks for how CPT code 81462 fits into molecular oncology testing portfolios, comparisons to adjacent codes such as unlisted molecular pathology procedures and broader genomic assays, and operational considerations for lab-based sequencing services. Data not available in the input are noted where applicable.
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Billing Code Overview
CPT code 81462 describes a liquid biopsy genomic sequencing panel performed on a plasma specimen to detect cell–free DNA (cfDNA) or DNA/RNA. The analysis evaluates nucleic acid sequence variants, copy number variants, and rearrangements that can impact the diagnosis and treatment of solid organ cancers.
Service type: Genomic sequencing (liquid biopsy) for oncology
Typical site of service: Clinical laboratory or outpatient laboratory setting; sample collection often occurs in an ambulatory clinic or hospital outpatient phlebotomy service.
National Reimbursement Benchmarks
BUCA’s average commercial rate for CPT 81462 sits at $1,015.80, providing a useful anchor for comparing major commercial payers. Blue Cross Blue Shield’s interquartile spread (P75–P25) is $500.10, UnitedHealth Group’s spread is $693.50, Cigna’s spread is $781.40, and Aetna’s spread is $425.20. These spreads indicate Cigna and UnitedHealth Group exhibit the widest price dispersion among the listed payers, while Aetna and Blue Cross Blue Shield show comparatively tighter clustering around their mid-range commercial payments.
Overall, the market centers near BUCA’s mean but with meaningful variation by payer: Cigna and UnitedHealth Group demonstrate the largest IQRs, suggesting greater variability in negotiated commercial rates, whereas Aetna and Blue Cross Blue Shield are the tightest on an IQR basis. Blue Cross Blue Shield and UnitedHealth Group also have high-end values that extend above BUCA’s average, contributing to broader upper-tail exposure for those payers.