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See a sample rate comparisonCPT 87267 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 Enterovirus Infection, This Test Detects The Presence Of An Enterovirus. This Virus Creates Symptoms Similar To A Cold Or Flu With A Rash.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component QW - CLIA Waived Tests 99 - Multiple Modifiers 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87267 |
| Medicaid Fee Schedule | View Medicaid rates for 87267 |
National average reimbursement for CPT 87267 by major payers:
$12.81
$9.08
$14.02
$19.49
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CPT 87267
5 of 25 sample ratesHigher to lower in this preview
Da Pediatric Rehabilitation
$60.00Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$16.01Published rateParish Hospital Service District For The Parish Of Orleans, New Orleans East Hospital
$12.07Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$8.01Published rateBrittany Ptachick
Hroa 401k Plan
$5.64Published rate
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See a sample payer proposalCPT 87267 vs. Other Microbiology Procedures Codes
The CPT 87267 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 87267 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 |
|---|---|---|
| 87265-CPT | Low | Infectious Agent Antigen Detec, Infectious Agent Antigen Detection By Direct Fluorescentantibody Technique Bordetella Pertussisparapertussis Infectious Agent Antigen Detection By Direct Fluorescent |
| 87267-CPT | Low | Test For Enterovirus Infection, This Test Detects The Presence Of An Enterovirus. This Virus Creates Symptoms Similar To A Cold Or Flu With A Rash. |
| 87269-CPT | Low | Giardia (Parasite) Test, The Test Examines A Stool Sample For The Giardia Parasite. Infection Causes Diarrhea Intestinal Cramping And Dehydration. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87267. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87267 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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