CPT 87045 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 87045 |
National average reimbursement for CPT 87045 by major payers:
$9.21
$6.80
$11.25
$14.29
| 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 87045 | ||||||
United | 87045 | $5.61 | 1689663007 - THE GOOD SHEPHERD HOSPITAL, INC., CHRISTUS GOOD SHEPHERD MEDICAL CENTER - LONGVIEW | 751041154 - (TX) GOOD SHEPHERD HOSPITAL INC | TX | General Acute Care Hospital (282N00000X) |
United | 87045 | $8.50 | 1942294939 - ST JOSEPH REGIONAL HEALTH CENTER, ST JOSEPH AMBULATORY SURGERY | 741282696 - ST JOSEPH REGIONAL HEALTH CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 87045 | $9.43 | 1982604021 - GEORGETOWN MEMORIAL HOSPITAL, TIDELANDS GEORGETOWN MEMORIAL HOSPITAL | 570341194 - GEORGETOWN MEMORIAL HOSPITAL | SC | General Acute Care Hospital (282N00000X) |
United | 87045 | $5.78 | 1689655912 - NOCONA HOSPITAL DISTRICT, NOCONA GENERAL HOSPITAL | 751368648 | TX | General Acute Care Hospital (282N00000X) |
United | 87045 | $12.39 | 1689676835 - NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT, NATCHITOCHES REGIONAL MEDICAL CENTER | 726013916 - (LA) NATCHITOCHES REGIONAL MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | 87045 | $9.43 | 1255384533 - COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP, MEDICAL CITY LEWISVILLE | 621682210 - (TX) DE MARKETING AND SALES | TX | General Acute Care Hospital (282N00000X) |
United | 87045 | $7.90 | 1881665164 - CLHG-LEESVILLE, BYRD REGIONAL HOSPITAL | 824337635 | LA | General Acute Care Hospital (282N00000X) |
United | 87045 | $9.43 | 1740450121 - HOUSTON NORTHWEST OPERATING COMPANY, LLC, HOUSTON NORTHWEST MEDICAL CENTER ACUTE | 261512163 | TX | General Acute Care Hospital (282N00000X) |
United | 87045 | $5.53 | 1134126659 - CALDWELL MEMORIAL HOSPITAL INC | 720878037 - (LA) CALDWELL MEMORIAL HOSPITAL, INC. | LA | General Acute Care Hospital (282N00000X) |
United | 87045 | $5.53 | 1699768705 - GONZALES HEALTHCARE SYSTEMS | 741625013 | TX | General Acute Care Hospital (282N00000X) |
United | 87045 | $3.96 | 1083903744 - HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST. BERNARD, STATE OF LOUIS, ST. BERNARD PARISH HOSPITAL | 261576974 - (LA) HOSPITAL SERVICE DISTRICT OF THE PARISH OF ST BERNARD STATE OF LOUIS | LA | Rural Acute Care Hospital (282NR1301X) |
United | 87045 | $10.38 | 1366428401 - AARON ASKEW | 931224010 - PRAXIS HEALTH, P.C. | OR | Orthopaedic Trauma Physician (207XX0801X) |
United | 87045 | $11.85 | 1396394961 - CLHG-ACADIAN, LLC, ACADIAN MEDICAL CENTER | 825359949 | LA | General Acute Care Hospital (282N00000X) |
United | 87045 | $8.50 | 1104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC | 208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | 87045 | $5.65 | 1679557888 - CHRISTUS HEALTH SOUTHEAST TEXAS, CHRISTUS SOUTHEAST TEXAS - ST. ELIZABETH | 760591590 - (TX) CHRISTUS HEALTH SOUTHEAST TEXAS | TX | 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 87045 vs. Other Microbiology Procedures Codes
The CPT 87045 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 87045 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 87045. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87045 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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