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See a sample rate comparisonCPT 87116 Fee Schedule
Last Verified: October 2026
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.
Test To Confirm Tuberculosis, This Test Verifies A Tuberculosis (Tb) Infection. Usually A Sample Of Mucus From A Cough Is Tested. The Sample Is Examined Under A Microscope And Some Is Placed Into A Substance That Encourages Tb Bacteria To Multiply.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 21 - Inpatient Hospital 81 - Independent Laboratory |
| Common Modifiers | None 26 - Professional component 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87116 |
| Medicaid Fee Schedule | View Medicaid rates for 87116 |
National average reimbursement for CPT 87116 by major payers:
$10.70
$7.49
$12.51
$16.25
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CPT 87116
5 of 25 sample ratesHigher to lower in this preview
Th Healthcare, Ltd, Nacogdoches Medical Center
$18.00Published rateVhs San Antonio Partners, LLC
$10.80Published rateMethodist Hospitals Of Dallas, Methodist Charlton Medical Center
Methodist Hospitals Of Dallas
$10.80Published rateSt Helena Parish Hospital, St Helena Parish Hospital
St Helena Parish Hospital
$9.28Published rateBsa Hospital LLC
$4.53Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87116 vs. Other Microbiology Procedures Codes
The CPT 87116 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 87116 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 |
|---|---|---|
| 87101-CPT | Low | Fungal Culture, A Sample Of Skin Hair Nail Blood Urine Stool Or Other Body Fluid Is Treated So That If Mold Or Yeast Spores Are Present They Will Grow (Multiply). |
| 87102-CPT | Low | Fungal Culture, A Sample Of Skin Hair Nail Blood Urine Stool Or Other Body Fluid Is Treated So That If Mold Or Yeast Spores Are Present They Will Grow (Multiply). |
| 87103-CPT | Low | Fungal Culture, A Sample Of Skin Hair Nail Blood Urine Stool Or Other Body Fluid Is Treated So That If Mold Or Yeast Spores Are Present They Will Grow (Multiply). |
| 87116-CPT | Low | Test To Confirm Tuberculosis, This Test Verifies A Tuberculosis (Tb) Infection. Usually A Sample Of Mucus From A Cough Is Tested. The Sample Is Examined Under A Microscope And Some Is Placed Into A Substance That Encourages Tb Bacteria To Multiply. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87116. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87116 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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