CPT 81463: Liquid Biopsy cfDNA Genomic Panel for Solid Tumors
Commercial payers pay $1192 on average nationally for this procedure.
CPT code 81463 describes a laboratory liquid biopsy genomic sequencing panel performed on a serum specimen to detect cell-free DNA (cfDNA) alterations — including sequence variants, copy number variants, and microsatellite instability (MSI) — that inform diagnosis and treatment of solid organ tumors; service type: genomic sequence analysis of cfDNA; typical site of service: clinical laboratory or reference molecular diagnostics laboratory using a serum sample.
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
National commercial rates for CPT 81463 cluster around BUCA’s average commercial benchmark of $1,192.40, with notable variation by carrier. Blue Cross Blue Shield (BCBS) and Cigna show higher central tendencies (medians $1,150.30 and $1,545.90 respectively), while Aetna and UnitedHealth Group sit lower on median. Cigna and BCBS present high ceilings (max $4,346.50 and $2,789.20) that pull their means up above BUCA’s average, indicating some outlier high contracts among commercial payers.
Examining dispersion (P75 minus P25) highlights where rates are most and least concentrated: Blue Cross Blue Shield has the widest interquartile spread at $575.80 ($1,524.70 - $934.90), followed by Cigna at $1,268.20 ($1,963.20 - $695.50) and BUCA at $597.60 ($1,497.60 - $790.20). UnitedHealth Group is the tightest at $679.30 ($1,345.30 - $565.00), with Aetna’s spread at $427.10 ($1,103.20 - $676.10), indicating relatively more compressed commercial contracting for Aetna and UnitedHealth Group compared with BCBS and Cigna.