{"procedure":{"code_type":"CPT","code":"81316","lay_name":"Leukemia gene fusion test for one breakpoint region","blurb":"Laboratory test on blood or bone marrow that looks for the PML/RARalpha gene fusion seen in acute promyelocytic leukemia; this code covers testing of a single breakpoint or breakpoint set.","slug":"cpt-81316-leukemia-gene-fusion-test-for-one-breakpoint-region","description":"PML/RARALPHA 1 BREAKPOINT","name_source":"llm:claude-opus-5","name_reviewed":false,"ccs":{"code":"234","label":"Pathology","surgery_flag":"n/a"}},"settings":{"outpatient":{"setting":"outpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-25T01:05:50.973703Z","filing_date_min":"2025-12-02","filing_date_max":"2026-09-22","checked_from":"2026-09-05T10:46:08.317859Z","checked_through":"2026-09-25T01:05:50.973703Z","n_priced_setters":3956,"n_filed":189,"n_usable":183,"n_not_usable":1,"n_labelled":4,"n_no_cash":1,"n_estimated":0,"n_states":27,"cash_p10":161.0,"cash_p20":207.31,"cash_p25":207.31,"cash_p50":307.13,"cash_p75":1114.2,"cash_p80":1347.0,"cash_p90":2928.8,"cash_mean_trimmed":450.31,"gross_p50":700.0,"cash_to_gross_p50":0.6,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AK","n":1,"p20":null,"p50":null,"p80":null},{"state":"AR","n":2,"p20":null,"p50":null,"p80":null},{"state":"AZ","n":1,"p20":null,"p50":null,"p80":null},{"state":"CA","n":21,"p20":2928.8,"p50":2928.8,"p80":2928.8},{"state":"FL","n":1,"p20":null,"p50":null,"p80":null},{"state":"GA","n":6,"p20":null,"p50":null,"p80":null},{"state":"HI","n":2,"p20":null,"p50":null,"p80":null},{"state":"IA","n":11,"p20":520.0,"p50":520.0,"p80":520.0},{"state":"IL","n":3,"p20":null,"p50":null,"p80":null},{"state":"IN","n":13,"p20":292.13,"p50":333.75,"p80":448.55},{"state":"KY","n":2,"p20":null,"p50":null,"p80":null},{"state":"LA","n":1,"p20":null,"p50":null,"p80":null},{"state":"MA","n":1,"p20":null,"p50":null,"p80":null},{"state":"MI","n":4,"p20":null,"p50":null,"p80":null},{"state":"MN","n":1,"p20":null,"p50":null,"p80":null},{"state":"MS","n":11,"p20":161.0,"p50":175.0,"p80":308.0},{"state":"NJ","n":22,"p20":207.31,"p50":228.04,"p80":228.04},{"state":"NV","n":2,"p20":null,"p50":null,"p80":null},{"state":"NY","n":12,"p20":207.31,"p50":207.31,"p80":207.31},{"state":"OH","n":1,"p20":null,"p50":null,"p80":null},{"state":"OK","n":2,"p20":null,"p50":null,"p80":null},{"state":"OR","n":3,"p20":null,"p50":null,"p80":null},{"state":"PA","n":27,"p20":27.3,"p50":548.0,"p80":1114.2},{"state":"TN","n":5,"p20":null,"p50":null,"p80":null},{"state":"TX","n":16,"p20":307.13,"p50":307.13,"p80":307.13},{"state":"VA","n":5,"p20":null,"p50":null,"p80":null},{"state":"WA","n":7,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":159,"p20":207.31,"p50":307.13,"p80":1489.0},{"key":"childrens","n":4,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":20,"p20":308.0,"p50":448.55,"p80":936.65}],"ownership":[{"key":"for_profit","n":11,"p20":null,"p50":null,"p80":null},{"key":"government","n":15,"p20":null,"p50":null,"p80":null},{"key":"nonprofit","n":157,"p20":207.31,"p50":308.0,"p80":1489.0}],"affiliation":[{"key":"affiliated","n":172,"p20":207.31,"p50":307.13,"p80":1489.0},{"key":"independent","n":11,"p20":null,"p50":null,"p80":null}]},"histogram":[{"lo":48.0,"hi":72.41,"n":1},{"lo":72.41,"hi":109.23,"n":2},{"lo":109.23,"hi":164.77,"n":8},{"lo":164.77,"hi":248.55,"n":44},{"lo":248.55,"hi":374.94,"n":38},{"lo":374.94,"hi":565.6,"n":20},{"lo":565.6,"hi":853.21,"n":8},{"lo":853.21,"hi":1287.06,"n":16},{"lo":1287.06,"hi":1941.53,"n":10},{"lo":1941.53,"hi":2928.8,"n":25}],"previous":null},"inpatient":{"setting":"inpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-25T01:05:50.973703Z","filing_date_min":"2025-12-17","filing_date_max":"2026-09-01","checked_from":"2026-09-05T11:47:26.045722Z","checked_through":"2026-09-25T01:05:50.973703Z","n_priced_setters":3956,"n_filed":110,"n_usable":106,"n_not_usable":0,"n_labelled":3,"n_no_cash":1,"n_estimated":0,"n_states":17,"cash_p10":137.9,"cash_p20":197.1,"cash_p25":287.0,"cash_p50":520.0,"cash_p75":1671.6,"cash_p80":2669.0,"cash_p90":2928.8,"cash_mean_trimmed":855.49,"gross_p50":700.0,"cash_to_gross_p50":0.6,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AR","n":2,"p20":null,"p50":null,"p80":null},{"state":"CA","n":21,"p20":2928.8,"p50":2928.8,"p80":2928.8},{"state":"GA","n":6,"p20":null,"p50":null,"p80":null},{"state":"HI","n":1,"p20":null,"p50":null,"p80":null},{"state":"IA","n":11,"p20":520.0,"p50":520.0,"p80":520.0},{"state":"IL","n":1,"p20":null,"p50":null,"p80":null},{"state":"KY","n":2,"p20":null,"p50":null,"p80":null},{"state":"MA","n":1,"p20":null,"p50":null,"p80":null},{"state":"MN","n":1,"p20":null,"p50":null,"p80":null},{"state":"MS","n":10,"p20":147.0,"p50":168.0,"p80":308.0},{"state":"NV","n":1,"p20":null,"p50":null,"p80":null},{"state":"OH","n":1,"p20":null,"p50":null,"p80":null},{"state":"PA","n":23,"p20":30.71,"p50":569.0,"p80":1180.8},{"state":"TN","n":4,"p20":null,"p50":null,"p80":null},{"state":"TX","n":14,"p20":307.13,"p50":307.13,"p80":307.13},{"state":"VA","n":5,"p20":null,"p50":null,"p80":null},{"state":"WA","n":2,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":95,"p20":168.0,"p50":520.0,"p80":2669.0},{"key":"childrens","n":3,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":8,"p20":null,"p50":null,"p80":null}],"ownership":[{"key":"for_profit","n":5,"p20":null,"p50":null,"p80":null},{"key":"government","n":2,"p20":null,"p50":null,"p80":null},{"key":"nonprofit","n":99,"p20":195.05,"p50":520.0,"p80":2928.8}],"affiliation":[{"key":"affiliated","n":102,"p20":197.1,"p50":520.0,"p80":2669.0},{"key":"independent","n":4,"p20":null,"p50":null,"p80":null}]},"histogram":[{"lo":33.39,"hi":52.23,"n":1},{"lo":52.23,"hi":81.7,"n":0},{"lo":81.7,"hi":127.8,"n":2},{"lo":127.8,"hi":199.92,"n":14},{"lo":199.92,"hi":312.72,"n":20},{"lo":312.72,"hi":489.17,"n":3},{"lo":489.17,"hi":765.19,"n":17},{"lo":765.19,"hi":1196.95,"n":9},{"lo":1196.95,"hi":1872.33,"n":9},{"lo":1872.33,"hi":2928.8,"n":25}],"previous":null}},"related":[{"code_type":"CPT","code":"88305","lay_name":"Tissue exam under microscope, moderate complexity","slug":"cpt-88305-tissue-exam-under-microscope-moderate-complexity"},{"code_type":"CPT","code":"88312","lay_name":"Special stain for germs such as bacteria or fungus","slug":"cpt-88312-special-stain-for-germs-such-as-bacteria-or-fungus"},{"code_type":"CPT","code":"88342","lay_name":"Special tissue stain for one marker, first stain","slug":"cpt-88342-special-tissue-stain-for-one-marker-first-stain"},{"code_type":"CPT","code":"88304","lay_name":"Tissue exam under microscope, low complexity","slug":"cpt-88304-tissue-exam-under-microscope-low-complexity"},{"code_type":"CPT","code":"88313","lay_name":"Special tissue stain for cell structures","slug":"cpt-88313-special-tissue-stain-for-cell-structures"},{"code_type":"CPT","code":"88307","lay_name":"Tissue exam under microscope, high complexity","slug":"cpt-88307-tissue-exam-under-microscope-high-complexity"},{"code_type":"CPT","code":"81241","lay_name":"Factor V Leiden blood clotting gene mutation test","slug":"cpt-81241-factor-v-leiden-blood-clotting-gene-mutation-test"},{"code_type":"CPT","code":"88302","lay_name":"Tissue exam under microscope, simplest level","slug":"cpt-88302-tissue-exam-under-microscope-simplest-level"},{"code_type":"CPT","code":"88184","lay_name":"Flow cytometry cell marker testing, first marker","slug":"cpt-88184-flow-cytometry-cell-marker-testing-first-marker"},{"code_type":"CPT","code":"88341","lay_name":"Special tissue stain for one more marker","slug":"cpt-88341-special-tissue-stain-for-one-more-marker"},{"code_type":"CPT","code":"88300","lay_name":"Tissue exam by eye only, no microscope","slug":"cpt-88300-tissue-exam-by-eye-only-no-microscope"},{"code_type":"CPT","code":"81240","lay_name":"Prothrombin blood clotting gene mutation test","slug":"cpt-81240-prothrombin-blood-clotting-gene-mutation-test"}]}