CPT 86787 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Pathology and Laboratory Procedures • Immunology Procedures |
| Common Place of Service | • 81 - Independent Laboratory • 11 - Office |
| Common Modifiers | • None • 90 - Reference Laboratory • 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 86787 |
National average reimbursement for CPT 86787 by major payers:

$11.48

$13.30

$15.62

$19.29
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 86787 | ||||||
United | 86787 | $10.69 | 1194716605 - SHANNON SULLIVAN | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physical Therapist (225100000X) |
United | 86787 | $5.40 | 1710935713 - JOHN RESTIVO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 86787 | $10.69 | 1164469755 - NATHANIEL GOULD | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physical Medicine & Rehabilitation Physician (208100000X) |
United | 86787 | $10.69 | 1962464818 - JOHN ELLIS | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 86787 | $5.40 | 1306453022 - ALISSA TUCCIARONE | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 86787 | $10.69 | 1093976847 - CATHERINE DOCOUS | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physician Assistant (363A00000X) |
United | 86787 | $5.40 | 1407840614 - MARIA GESUALDO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 86787 | $5.40 | 1124627674 - LAUREN PLATT | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 86787 | $10.69 | 1447576319 - ELIZABETH WESTEN | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 86787 | $11.59 | 1134222565 - LAFAYETTE SURGICAL HOSPITAL LLC, LAFAYETTE SURGICAL SPECIALTY HOSPITAL | 900021727 - (LA) LAFAYETTE SURGICAL SPECIALTY HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 86787 | $10.69 | 1588379333 - KAREN ALLARD | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 86787 | $10.69 | 1497534705 - MICHELLE PALUMBO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 86787 | $14.81 | 1053796250 - STEPHANIE CALENZO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physician Assistant (363A00000X) |
United | 86787 | $10.69 | 1538135777 - TIMOTHY KENDRICK | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physician Assistant (363A00000X) |
United | 86787 | $10.69 | 1710935713 - JOHN RESTIVO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 86787 vs. Other Immunology Procedures Codes
The CPT 86787 code is part of the Pathology and Laboratory Procedures services used for Immunology Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 86787 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86787. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86787 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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