Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 87210 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.
Test For Cause Of Infection, This Test Is Done To Find The Cause Of An Infection. A Sample Is Collected With A Moist Swab And Smeared Onto A Slide. Often A Stain Is Added To The Sample To Help See Bacteria Fungi Or Parasites That May Be Present.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | None QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87210 |
| Medicaid Fee Schedule | View Medicaid rates for 87210 |
National average reimbursement for CPT 87210 by major payers:
$5.28
$4.65
$6.64
$8.34
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 87210.
CPT 87210
5 of 25 sample ratesHigher to lower in this preview
Jeannette Andrews
Mainehealth
$9.53Published rateEse Efemini
Womens Care Florida, LLP
$5.44Published rateDavid Ossin
Osceola Surgical Associates LLC
$3.49Published rateMiguel Gonzalez
$2.72Published rateInstitute For Women'S Health And Body, LLC
$2.61Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 87210 vs. Other Microbiology Procedures Codes
The CPT 87210 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 87210 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. |
| 87210-CPT | Low | Test For Cause Of Infection, This Test Is Done To Find The Cause Of An Infection. A Sample Is Collected With A Moist Swab And Smeared Onto A Slide. Often A Stain Is Added To The Sample To Help See Bacteria Fungi Or Parasites That May Be Present. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87210. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87210 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 87210) and we'll show you how you compare in 15 minutes or less.