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See a sample rate comparisonCPT 87206 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.
Microscopic Lab Test, This Test Is Done To Find Which Organism Is Causing An Infection. A Fluid Or Tissue Sample Is Smeared Onto A Slide Or Container And A Stain Is Added To Help See Bacteria Viruses Parasites Or Cells.
| 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 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87206 |
| Medicaid Fee Schedule | View Medicaid rates for 87206 |
National average reimbursement for CPT 87206 by major payers:
$5.52
$3.87
$6.58
$8.05
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CPT 87206
5 of 25 sample ratesHigher to lower in this preview
Nicole Shafran
Neuroscience Group Of Northeast Wisconsin, S.C.
$13.27Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Spartanburg
Prisma Health - Upstate
$4.84Published rateDennis Crockett
Head And Neck Associates Of Orange County, Inc.
$3.15Published rateMargaret Booth-Jones
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$3.15Published rateTodd Stinard
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$2.75Published rate
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See a sample payer proposalCPT 87206 vs. Other Microbiology Procedures Codes
The CPT 87206 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 87206 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 |
|---|---|---|
| 87197-CPT | Low | Test To Select Antibiotic, The Antibiotic Sensitivity Test Measures The Reaction Of Bacteria To An Antibiotic. The Result May Be Indicated As Sensitive Susceptible Indeterminate (No Clear Effect) Or Resistant. |
| 87205-CPT | Low | Microscopic Lab Test, This Test Is Done To Find Which Organism Is Causing An Infection. A Fluid Or Tissue Sample Is Smeared Onto A Slide Or Container And A Stain Is Added To Help See Bacteria Viruses Parasites Or Cells. |
| 87206-CPT | Low | Microscopic Lab Test, This Test Is Done To Find Which Organism Is Causing An Infection. A Fluid Or Tissue Sample Is Smeared Onto A Slide Or Container And A Stain Is Added To Help See Bacteria Viruses Parasites Or Cells. |
| 87207-CPT | Low | Microscopic Lab Test, This Test Is Done To Find Which Organism Is Causing An Infection. A Fluid Or Tissue Sample Is Smeared Onto A Slide Or Container And A Stain Is Added To Help See Bacteria Viruses Parasites Or Cells. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87206. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87206 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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