CPT 87071 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 11 - Office |
| Common Modifiers | None 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87071 |
| Medicaid Fee Schedule | View Medicaid rates for 87071 |
National average reimbursement for CPT 87071 by major payers:
$9.82
$6.90
$11.06
$14.08
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 87071 | $5.54 | 1730106824 - NEVADA EYE CARE PROFESSIONALS LITTLE & STEIN, LTD. | 880316581 - NEVADA EYE CARE PROFESSIONALS | NV | Single Specialty Group (193400000X) |
United | 87071 | $9.89 | 1982800397 - PELHAM MEDICAL CENTER | 141996067 | SC | General Acute Care Hospital (282N00000X) |
United | 87071 | $8.89 | 1114473212 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-FARIS | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 87071 | $17.48 | 1184622847 - CHI ST. LUKE'S HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER | 741161938 - CHI ST LUKES HEALTH BAYLOR COLLEGE OF MEDICINE MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 87071 | $12.94 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 87071 | $35.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 87071 | $40.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 87071 | $9.55 | 1972501252 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 87071 | $11.75 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 87071 | $9.89 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 87071 | $12.94 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 87071 | $9.55 | 1821097627 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 87071 | $4.68 | 1588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | 463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | NY | Multi-Specialty Group (193200000X) |
United | 87071 | $4.15 | 1053866707 - BRITTANY PTACHICK | 541958039 - HROA 401K PLAN | VA | Family Nurse Practitioner (363LF0000X) |
United | 87071 | $9.89 | 1659323772 - COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP, MEDICAL CITY FORT WORTH | 621682202 - (TX) COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP | 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 87071 vs. Other Microbiology Procedures Codes
The CPT 87071 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 87071 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 | Control Test For Infection, The Test Is Used To Diagnose An Infection By Injecting A Small Amount Of The Test Sample Into A Small Animal. The Animal Is Observed For Signs Of An Infection For Up To Three Weeks. |
| 87015-CPT | Low | Infection Test Concentration, This Test Method Identifies Bacteria Or Parasites That Are The Cause Of An Infection. The Sample Is Concentrated So That The Infection Organisms Collect Together. |
| 87040-CPT | Low | Blood Test Bacteria Infection, This Test Identifies Early Signs Of A Bacterial Growth And Thus Infection In A Blood Sample. Infections In The Blood (Bacteremia Or Sepsis) Can Cause Serious Illness. |
| 87071-CPT | Low | Test For Bacteria Infection, A Sample Of Body Fluid Or Tissue Is Tested For Infectious Bacteria. One Or More Additional Tests Confirm The Result Identify The Bacteria And Estimate How Many Are Present. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87071. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87071 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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