Cost analysis for CPT 81518 — Mrna gene analysis of 11 genes in breast tumor tissue
Average Medicare Payment
$3784.78
2023 data
Total Payments (2023)
$34.2M
Services (2023)
9.0K
Price Change (2019–2023)
-0.2%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2019 | $3792.59 | $6.9M | 1.8K | — |
| 2020 | $3838.44 | $8.7M | 2.3K | +1.2% |
| 2021 | $3864.62 | $21.2M | 5.5K | +0.7% |
| 2022 | $3813.05 | $27.9M | 7.3K | -1.3% |
| 2023 | $3784.78 | $34.2M | 9.0K | -0.7% |
The most expensive state pays 1.0x more than the cheapest for this procedure. CA averages $3784.78 vs CA at $3784.78.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| CA | $3784.78 | $34.2M | 9.0K | 1 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Biotheranostics, Inc. | Clinical Laboratory | CA | $34.2M | 9.0K | $3784.78 |
Based on the data, CPT 81518 shows a 1.0x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 0.2% since 2019. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.