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CPT 87118 Fee Schedule

Last Verified: December 2025

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.

Cult,Mycobacteria,Defin.Id Ea Organ
Key FactDetail
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 LevelLow

National average reimbursement for CPT 87118 by major payers:

bcbs

$13.58

uhc

$9.05

aetna

$15.31

cigna

$21.41

Preview provider-level rates for...
For billing codeCPT 87118
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 87118

United
87118$14.601306865761 - HOSPITAL SERVICE DISTRICT NO. 1 OF CALDWELL PARISH, CITIZENS MEDICAL CENTER720862035 - (LA) CITIZENS MEDICAL CENTERLAGeneral Acute Care Hospital (282N00000X)
United
87118$14.601205189172 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL OVERLOOK452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLCTXGeneral Acute Care Hospital (282N00000X)
United
87118$9.591306843826 - WEST CARROLL HEALTH SYSTEMS LLC, WEST CARROLL MEMORIAL HOSPITAL562300247 - WEST CARROLL HEALTH SYSTEMS L.L.C.LAGeneral Acute Care Hospital (282N00000X)
United
87118$14.601629021845 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, NORTH AUSTIN MEDICAL CENTER742781812TXGeneral Acute Care Hospital (282N00000X)
United
87118$6.131316505043 - ETHICUS HOSPITAL DFW LLC, LEGENT ORTHOPEDIC HOSPITAL263044485 - (TX) ETHICUS HOSPITAL DFWTXGeneral Acute Care Hospital (282N00000X)
United
87118$6.131831220904 - METHODIST HOSPITAL PLAINVIEW TEXAS, COVENANT HOSPITAL PLAINVIEW752426010 - (TX) METHODIST HOSPITAL PLAINVIEW TEXASTXGeneral Acute Care Hospital (282N00000X)
United
87118$14.601629021845 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, NORTH AUSTIN MEDICAL CENTER742781812TXGeneral Acute Care Hospital (282N00000X)
United
87118$14.601144274226 - NAVARRO HOSPITAL LP, NAVARRO REGIONAL HOSPITAL621762428TXGeneral Acute Care Hospital (282N00000X)
United
87118$14.601376591941 - HOSPITAL SERVICE DISTRICT 1 OF EAST BATON ROUGE PARISH, LANE REGIONAL MEDICAL CENTER726015227LAGeneral Acute Care Hospital (282N00000X)
United
87118$14.601902857766 - COLUMBIA MEDICAL CENTER OF LAS COLINAS INC, MEDICAL CITY LAS COLINAS621650582 - (TX) COLUMBIA MEDICAL CENTER OF LAS COLINAS INCTXGeneral Acute Care Hospital (282N00000X)
United
87118$14.601417941295 - UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT TYLER756001354TXGeneral Acute Care Hospital (282N00000X)
United
87118$18.351972517365 - COVENANT MEDICAL CENTER822913146 - (TX) COVENANT MEDICAL CENTERTXGeneral Acute Care Hospital (282N00000X)
United
87118$6.261669480323 - KELL WEST REGIONAL HOSPITAL LLC752756307 - KELL WEST REGIONAL HOSPITAL, LLCTXGeneral Acute Care Hospital (282N00000X)
United
87118$6.131689650921 - EASTLAND MEMORIAL HOSPITAL DISTRICT, EASTLAND MEMORIAL HOSPITAL752313255TXGeneral Acute Care Hospital (282N00000X)
United
87118$8.771649262791 - SABINE MEDICAL CENTER INC, SABINE MEDICAL CENTER262074318LAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 87118 vs. Other Microbiology Procedures Codes

The CPT 87118 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 87118 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.

CodeComplexityDescription
87103-CPTLowCulture, Fungi, Isolation; Blood
87106-CPTLowCulture, Fungi, Definitive Identification Of Each Fungus (Use In Addition To Codes 87101, 87102, Or 87103 When Appropriate)
87109-CPTLowCulture, Mycoplasma, Any Source
87118-CPTLowCult,Mycobacteria,Defin.Id Ea Organ

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87118. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 87118 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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