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 |
| CMS | $17.14 Physician Fee Schedule |
National average reimbursement for CPT 87207 by major payers:
$12.49
$4.53
$7.68
$22.95
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 87207 | ||||||
United | 87207 | $5.98 | 1588631311 - SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC, SURGICAL SPECIALTY CENTER OF BATON ROUGE | 263120962 - (LA) SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC | LA | General Acute Care Hospital (282N00000X) |
United | 87207 | $3.44 | 1669480323 - KELL WEST REGIONAL HOSPITAL LLC | 752756307 - KELL WEST REGIONAL HOSPITAL, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $7.19 | 1275581852 - ROLLING PLAINS MEMORIAL HOSPITAL | 756003896 - (TX) THE NOLAN COUNTY HOSPITAL DISTRICT | 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 | $3.51 | 1932123247 - DALLAS COUNTY HOSPITAL DISTRICT, PARKLAND HEALTH | 756004221 - DALLAS COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1437102639 - COLUMBIA MEDICAL CENTER OF MCKINNEY SUBSIDIARY LP, MEDICAL CITY MCKINNEY | 621682207 - (TX) COLUMBIA MEDICAL CENTER OF MCKINNEY SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $24.00 | 1114473329 - EMERUS BHS SA THOUSAND OAKS LLC, BAPTIST NEIGHBORHOOD HOSPITAL SHAVANO PARK | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1326485749 - SOUTHERN REGIONAL MEDICAL CORPORATION, LEONARD J. CHABERT MEDICAL CENTER | 462743282 | LA | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1306897277 - COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP, MEDICAL CITY DENTON | 621682213 - (TX) COLUMBIA MEDICAL CENTER OF DENTON SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1477516466 - SCOTT & WHITE MEMORIAL HOSPITAL, BAYLOR SCOTT & WHITE MEDICAL CENTER - TEMPLE | 741166904 - SCOTT & WHITE MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $8.02 | 1720033947 - ST. DAVIDS HEALTHCARE PARTNERSHIP, L.P., LLP, HEART HOSPITAL OF AUSTIN | 743001674 - (TX) LONE STAR CIRCLE OF CARE | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1841237807 - CHCA MAINLAND, L.P., MAINLAND MEDICAL CENTER | 621801360 | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $3.58 | 1295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM | 752616977 - CHRISTUS TRINITY CLINIC | TX | General Acute Care Hospital (282N00000X) |
United | 87207 | $5.98 | 1447230388 - OPELOUSAS GENERAL HOSPITAL AUTHORITY | 720708111 | LA | 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 | 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 | Serum Bactericidal Titer (Schlichter Test) |
| 87205-CPT | Low | Smear, Primary Source, With Interpretation;Gram Or Giemsa Stain For Bacteria,Fungi, Or Cell Types |
| 87206-CPT | Low | Smear, Primary Source With Interpretation; Fluorescent And/Or Acid Fast Stain For Bacteria, Fungi, Parasites, Viruses Or Cell Types |
| 87207-CPT | Low | Special Stain For Inclusion Bodies Or Parasites (Eg Malaria Coccidia Microsporidia Trypanosomes Herpes Viruses) (Desc Rev 01/01/03) Galovirus Herpes Viruses) |
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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