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See a sample rate comparisonCPT 87164 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.
Microscope Exam Of Bacteria, Bacteria Called Spirochetes Can Be Identified With A Staining Method Known As A Dark Field. This Stain Is Useful For Diagnosing Syphilis And Lyme Disease Among Others.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 71 - Public Health Clinic 20 - Urgent Care Facility 11 - Office |
| Common Modifiers | None 26 - Professional component QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87164 |
| Medicaid Fee Schedule | View Medicaid rates for 87164 |
National average reimbursement for CPT 87164 by major payers:
$16.44
$7.33
$11.90
$25.37
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CPT 87164
5 of 25 sample ratesHigher to lower in this preview
Citizens Medical Center County Of Victoria, County Of Victoria Citizens Medical Center
$29.23Published rateWeatherford Health Services, LLC, Medical City Weatherford
Weatherford Health Services LLC
$10.73Published rateVhs Brownsville Hospital Company LLC, Valley Baptist Medical Center - Brownsville
$10.73Published rateWilbarger County Hospital District, Wilbarger General Hospital
Wilbarger General Hospital Employee Benefit Plan
$6.38Published rateBsa Hospital LLC
$4.51Published rate
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See a sample payer proposalCPT 87164 vs. Other Microbiology Procedures Codes
The CPT 87164 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 87164 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 |
|---|---|---|
| 87164-CPT | Low | Microscope Exam Of Bacteria, Bacteria Called Spirochetes Can Be Identified With A Staining Method Known As A Dark Field. This Stain Is Useful For Diagnosing Syphilis And Lyme Disease Among Others. |
| 87166-CPT | Low | Microscope Exam Of Bacteria, Bacteria Called Spirochetes Can Be Identified With A Staining Method Known As A Dark Field. This Stain Is Useful For Diagnosing Syphilis And Lyme Disease Among Others. |
| 87168-CPT | Low | Insect Examination, Visual Examination (Not By Microscope) Of An Insect From The Class Of Arthropods. These Insects Include Spiders. |
| 87169-CPT | Low | Parasite Examination, Visual Examination Of A Sample Containing Parasites Without The Aid Of A Microscope Or Other Lens. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87164. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87164 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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