CPT 87207 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87207 |
National average reimbursement for CPT 87207 by major payers:
$12.49
$4.53
$7.68
$22.47
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 87207 | $3.43 | 1407191984 - BSA HOSPITAL LLC | 300754305 | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $7.53 | 1245878990 - HUNTSVILLE COMMUNITY HOSPITAL, INC. | 843654542 - (TX) HUNTSVILLE COMMUNITY HOSPITAL INC | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $2.79 | 1831220904 - METHODIST HOSPITAL PLAINVIEW TEXAS, COVENANT HOSPITAL PLAINVIEW | 752426010 - (TX) METHODIST HOSPITAL PLAINVIEW TEXAS | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $8.36 | 1275633604 - EL PASO VAMC | 742934770 | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1306865761 - HOSPITAL SERVICE DISTRICT NO. 1 OF CALDWELL PARISH, CITIZENS MEDICAL CENTER | 720862035 - (LA) CITIZENS MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | 87207 | $24.00 | 1538667035 - CARTHAGE HOSPITAL, LLC | 824005981 | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $14.22 | 1346611829 - AMARI THOMAS | 300520570 - (TX) METHODIST HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $24.00 | 1861994808 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE NORTHEAST CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $24.00 | 1730697350 - JACKSONVILLE HOSPITAL LLC, UTHEALTH EAST TEXAS JACKSONVILLE HOSPITAL | 824037220 | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1841843455 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE EMERGENCY ROOM MONTWOOD | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $3.59 | 1316936990 - EL PASO COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER OF EL PASO | 752668018 | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1114998911 - GRANBURY HOSPITAL CORPORATION, LAKE GRANBURY MEDICAL CENTER | 752682017 - (TX) GRANBURY HOSPITAL CORPORATION | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1447230388 - OPELOUSAS GENERAL HOSPITAL AUTHORITY | 720708111 | LA | General Acute Care Hospital (282N00000X) |
United | 87207 | $3.56 | 1013212448 - GUSTAVO DELGADO | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.01 | 1972590602 - PALO PINTO COUNTY HOSPITAL DISTRICT, PALO PINTO GENERAL HOSPITAL | 751256948 | TX | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 87207 vs. Other Microbiology Procedures Codes
The CPT 87207 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 87207 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 87207. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87207 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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