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See a sample rate comparisonCPT 87166 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 | 81 - Independent Laboratory 20 - Urgent Care Facility |
| Common Modifiers | None 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87166 |
| Medicaid Fee Schedule | View Medicaid rates for 87166 |
National average reimbursement for CPT 87166 by major payers:
$11.75
$7.64
$12.33
$17.01
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CPT 87166
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$55.00Published rateSan Antonio Vamc, Kerrville Vamc
$15.77Published rateCrescent City Surgical Centre Operating Company, L.L.C.
Crescent City Surgical Centre
$11.30Published rateProgressive Acute Care Avoyelles, LLC, Avoyelles Hospital
$10.17Published rateAlexander Tran Md PA
$4.75Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87166 vs. Other Microbiology Procedures Codes
The CPT 87166 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 87166 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 87166. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87166 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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