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See a sample rate comparisonCPT 87220 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 Exam Of Sample, Samples From The Skin Hair Or Nails Are Examined Under A Microscope For The Presence Of Mold Or Yeast Spores Parasites Or Their Eggs.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 20 - Urgent Care Facility 11 - Office 81 - Independent Laboratory |
| Common Modifiers | None 26 - Professional component QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87220 |
| Medicaid Fee Schedule | View Medicaid rates for 87220 |
National average reimbursement for CPT 87220 by major payers:
$4.32
$3.99
$5.56
$6.44
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CPT 87220
5 of 25 sample ratesHigher to lower in this preview
Jessica Fewkes
Mass General Brigham Incorporated
$24.48Published rateKenneth M Reed Md PC, <Unavail>
Kenneth M. Reed, M.D., P.C.
$4.26Published rateLenzy Dermatology PC, <Unavail>
Lenzy Dermatology, PC
$4.26Published rateGonzales Healthcare Systems, Memorial Hospital
$3.57Published ratePeter Chien
Peter Chien Md PLLC
$1.91Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87220 vs. Other Microbiology Procedures Codes
The CPT 87220 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 87220 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 |
|---|---|---|
| 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. |
| 87220-CPT | Low | Microscopic Exam Of Sample, Samples From The Skin Hair Or Nails Are Examined Under A Microscope For The Presence Of Mold Or Yeast Spores Parasites Or Their Eggs. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87220. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87220 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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