CPT 87076 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 |
National average reimbursement for CPT 87076 by major payers:
$7.99
$5.77
$9.32
$12.57
| 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 87076 | ||||||
United | 87076 | $11.28 | 1548588841 - HARLINGEN VAMC | 272466786 | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $60.00 | 1275235426 - EMERUS BHS SA THOUSAND OAKS LLC | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $8.07 | 1609807122 - SPARTANBURG MEDICAL CENTER | 576000934 | SC | General Acute Care Hospital (282N00000X) |
United | 87076 | $4.19 | 1295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM | 752796815 - CHRISTUS HEALTH ARK-LA-TEX | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $4.96 | 1689655912 - NOCONA HOSPITAL DISTRICT, NOCONA GENERAL HOSPITAL | 751368648 | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $13.32 | 1598750721 - HUNT MEMORIAL HOSPITAL DISTRICT, HUNT REGIONAL | 751277293 - (TX) HUNT MEMORIAL HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $6.59 | 1467442418 - NORTHWEST TEXAS HEALTHCARE SYSTEM INC, NORTHWEST TEXAS HEALTHCARE SYSTEM | 232238976 | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $4.86 | 1316936990 - EL PASO COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER OF EL PASO | 752668018 | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $7.26 | 1083661409 - LALLIE KEMP MEDICAL CTR, LALLIE KEMP REGIONAL MEDICAL CENTER | 726000749 | LA | Critical Access Hospital (282NC0060X) |
United | 87076 | $4.73 | 1275581852 - ROLLING PLAINS MEMORIAL HOSPITAL | 756003896 - (TX) THE NOLAN COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $4.80 | 1316931835 - WILBARGER COUNTY HOSPITAL DISTRICT, WILBARGER GENERAL HOSPITAL | 756047638 - (TX) WILBARGER GENERAL HOSPITAL EMPLOYEE BENEFIT PLAN | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $8.07 | 1417465824 - ATHENS HOSPITAL, LLC | 823934511 | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $8.07 | 1275235426 - EMERUS BHS SA THOUSAND OAKS LLC | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $8.07 | 1861994808 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE NORTHEAST CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 87076 | $4.73 | 1194983510 - LYNN COUNTY HOSPITAL DISTRICT | 751328354 - (TX) LYNN COUNTY HOSPITAL DISTRICT | 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 87076 vs. Other Microbiology Procedures Codes
The CPT 87076 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 87076 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 |
|---|---|---|
| 87073-CPT | Low | Culture, Bacterial; Quantitative, Anaerobic With Isolation And Presumptive Identification Of Isolates, Any Source Except Urine, Blood Or Stool |
| 87075-CPT | Low | Culture Bacterial; Any Source Except Blood Anaerobic With Isolation And Presumptive Identification Of Isolates (Rvsd 1/1/04) |
| 87076-CPT | Low | Cult,Bac,Any Srce;Defin.Id,Ea.Ana |
| 87077-CPT | Low | Culture, Bacterial; Aerobic Isolate, Additional Methods, Each Isolate |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87076. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87076 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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