CPT 87015 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 • Microbiology Procedures |
| Common Place of Service | • 81 - Independent Laboratory • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87015 |
National average reimbursement for CPT 87015 by major payers:
$6.69
$4.64
$7.64
$9.90
| 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 87015 | ||||||
United | 87015 | $16.45 | 1447996863 - ALISON MARTIN | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Physical Therapist (225100000X) |
United | 87015 | $16.45 | 1295284560 - JAIME VELIE | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Family Nurse Practitioner (363LF0000X) |
United | 87015 | $16.45 | 1568605962 - JONATHAN HALL | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | NY | Physical Medicine & Rehabilitation Physician (208100000X) |
United | 87015 | $16.94 | 1588941975 - BILLIE STURGEON | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Nurse Practitioner (363L00000X) |
United | 87015 | $16.45 | 1578516803 - THE NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN SC, NEUROSCIENCE GROUP | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Neurological Surgery Physician (207T00000X) |
United | 87015 | $6.67 | 1215969787 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE SIERRA CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 87015 | $16.45 | 1356382535 - THOMAS MATTIO | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Neurology Physician (2084N0400X) |
United | 87015 | $16.45 | 1386665925 - TODD PEEBLES | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | VT | Neuroradiology Physician (2085N0700X) |
United | 87015 | $6.67 | 1982800397 - PELHAM MEDICAL CENTER | 141996067 | SC | General Acute Care Hospital (282N00000X) |
United | 87015 | $16.45 | 1144656851 - DACY REIMER | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Adult Health Nurse Practitioner (363LA2200X) |
United | 87015 | $2.80 | 1720033947 - ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP, HEART HOSPITAL OF AUSTIN | 743001674 - (TX) LONE STAR CIRCLE OF CARE | TX | General Acute Care Hospital (282N00000X) |
United | 87015 | $6.01 | 1902352008 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-SPARTANBURG | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 87015 | $16.45 | 1235785478 - ARIENNE KRIZENESKY | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Family Nurse Practitioner (363LF0000X) |
United | 87015 | $16.45 | 1710979935 - ROBERT DAUL | 391731465 - (WI) NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C. | WI | Physical Therapist (225100000X) |
United | 87015 | $6.67 | 1821026816 - EAST COOPER COMMUNITY HOSPITAL, INC., EAST COOPER MEDICAL CENTER | 934555562 | SC | General Acute Care Hospital (282N00000X) |
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 87015 vs. Other Microbiology Procedures Codes
The CPT 87015 code is part of the Pathology and Laboratory Procedures services used for Microbiology 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 87015 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.
| Code | Complexity | Description |
|---|---|---|
| 87003-CPT | Low | Anim Inocul,Sml Anim;W Observ/Dis |
| 87015-CPT | Low | Concent,For Parasites,Ova,Tb,Afb |
| 87040-CPT | Low | Culture Bacterial; Blood Aerobic With Isolation And Presumptive Identification Of Isolates (Includes Anaerobic Culture If Appropriate) (Rvsd 1/1/04) |
| 87045-CPT | Low | Culturre, Bacterial, Definitive; Stool, Aerobic, With Isolation And Preliminary Examination, (Eg, Kia, Lia), Salmonella And Shigella Species |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87015. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87015 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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