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See a sample rate comparisonCPT 87252 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.
Virus Identification Test, Test To Identify A Virus From Nose Throat Or Eye Secretions Urine Spinal Fluid Or Tissue. The Sample May Be Stained Or Treated To Enable Viral Organisms To Multiply And Is Examined Under A Microscope.
| 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 87252 |
| Medicaid Fee Schedule | View Medicaid rates for 87252 |
National average reimbursement for CPT 87252 by major payers:
$25.21
$18.21
$29.40
$38.83
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CPT 87252
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$57.35Published rateChristopher Raio
St Joseph Hospital
$34.41Published rateHospital Service District 2 Of The Parish Of Tangipahoa State Of La., Hood Memorial Hospital
Hospital Service District 2 Of The Parish Of Tangipahoa State Of La
$26.06Published rateMichael Shuler
Athens Orthopedic Clinic, PA
$15.64Published rateMark Vital
Hea Clinic, P.A., Dba Houston Eye Associates
$10.95Published rate
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See a sample payer proposalCPT 87252 vs. Other Microbiology Procedures Codes
The CPT 87252 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 87252 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 |
|---|---|---|
| 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. |
| 87250-CPT | Low | Virus Identification Test, Test To Identify A Virus From Nose Throat Or Eye Secretions Urine Spinal Fluid Or Tissue. The Sample May Be Stained Or Treated To Enable Viral Organisms To Multiply And Is Examined Under A Microscope. |
| 87252-CPT | Low | Virus Identification Test, Test To Identify A Virus From Nose Throat Or Eye Secretions Urine Spinal Fluid Or Tissue. The Sample May Be Stained Or Treated To Enable Viral Organisms To Multiply And Is Examined Under A Microscope. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87252. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87252 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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