Cost analysis for CPT 81519 — Test for detecting genes associated with breast cancer
Average Medicare Payment
$3779.96
2023 data
Total Payments (2023)
$94.7M
Services (2023)
25.0K
Price Change (2015–2023)
+13.3%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2015 | $3336.82 | $56.1M | 16.8K | — |
| 2016 | $3336.27 | $59.6M | 17.9K | -0.0% |
| 2017 | $3362.17 | $59.9M | 17.8K | +0.8% |
| 2018 | $3782.58 | $76.6M | 20.3K | +12.5% |
| 2019 | $3787.37 | $83.2M | 22.0K | +0.1% |
| 2020 | $3838.99 | $76.6M | 20.0K | +1.4% |
| 2021 | $3865.39 | $92.6M | 24.0K | +0.7% |
| 2022 | $3806.33 | $93.2M | 24.5K | -1.5% |
| 2023 | $3779.96 | $94.7M | 25.0K | -0.7% |
The most expensive state pays 1.0x more than the cheapest for this procedure. CA averages $3779.96 vs CA at $3779.96.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| CA | $3779.96 | $94.7M | 25.0K | 1 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Genomic Health, Inc. | Clinical Laboratory | CA | $94.7M | 25.0K | $3779.96 |
Based on the data, CPT 81519 shows a 1.0x variation in pricing across states — relatively consistent by Medicare standards.
Costs have increased 13.3% since 2015. 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.