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See a sample rate comparisonCPT 87230 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.
Identify Toxic Stool Bacteria, This Is A Stool Test To Identify The Cause Of Diarrhea. It Detects Toxins From Infectious Bacteria Such As E. Coli Clostridium Difficile And Vibrio Cholera.
| 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 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87230 |
| Medicaid Fee Schedule | View Medicaid rates for 87230 |
National average reimbursement for CPT 87230 by major payers:
$20.01
$13.98
$22.39
$29.29
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CPT 87230
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$43.43Published rateBaycare Home Care, Inc.
Baycare Home Care Inc
$19.96Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Faris
Prisma Health - Upstate
$17.77Published rateChristopher Raio
St Joseph Hospital
$11.98Published rateBrittany Ptachick
Hroa 401k Plan
$8.29Published rate
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See a sample payer proposalCPT 87230 vs. Other Microbiology Procedures Codes
The CPT 87230 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 87230 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 |
|---|---|---|
| 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. |
| 87209-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. |
| 87230-CPT | Low | Identify Toxic Stool Bacteria, This Is A Stool Test To Identify The Cause Of Diarrhea. It Detects Toxins From Infectious Bacteria Such As E. Coli Clostridium Difficile And Vibrio Cholera. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87230. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87230 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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