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CPT 87272 Fee Schedule

Last Verified: December 2025

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.

Antigen Detection By Fluorescent Antibody; Cryptosporidium/Giardia
Key FactDetail
Service Type

Pathology and Laboratory Procedures

Microbiology Procedures

Common Place of Service

81 - Independent Laboratory

22 - On Campus Outpatient Hospital

Common Modifiers

None

26 - Professional component

90 - Reference Laboratory

Complexity LevelLow

National average reimbursement for CPT 87272 by major payers:

bcbs

$11.88

uhc

$8.71

aetna

$13.15

cigna

$18.20

Preview provider-level rates for...
For billing codeCPT 87272
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 87272

United
87272$12.111013915149 - BAYCARE HOME CARE, INC., DBA SARASOTA MEMORIAL HOME CARE593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
87272$6.901760429831 - BRUCE MADSEN930590581 - EYECARE ASSOCIATES PCOROphthalmology Physician (207W00000X)
United
87272$6.691366400376 - SUNRISE HOME HEALTH CARE INC.650307774 - (FL) SUNRISE HOME HEALTH CARE INCFLHome Health Agency (251E00000X)
United
87272$12.111821081720 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
87272$7.031447317110 - BAPTIST HEALTH CARE, INC., BAPTIST HOME HEALT CARE AND MEDICAL EQUIPMENT590657322 - BAPTIST HEALTH CARE INCFLHome Health Agency (251E00000X)
United
87272$35.001801164967 - DA PEDIATRIC REHABILITATION270939565 - (FL) DA PEDIATRIC REHABILITATIONFLHome Health Agency (251E00000X)
United
87272$4.191598375651 - E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC, E AND A HEALTHCARE ON THE GO832289173 - (FL) E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLCFLHome Health Agency (251E00000X)
United
87272$55.001801164967 - DA PEDIATRIC REHABILITATION270939565 - (FL) DA PEDIATRIC REHABILITATIONFLHome Health Agency (251E00000X)
United
87272$4.191598375651 - E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC, E AND A HEALTHCARE ON THE GO832289173 - (FL) E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLCFLHome Health Agency (251E00000X)
United
87272$7.031457358103 - BELLVILLE HOSPITAL DISTRICT, BELLVILLE GENERAL HOSPITAL274005511 - BELLVILLE MEDICAL CENTERTXGeneral Acute Care Hospital (282N00000X)
United
87272$6.471255478004 - CHRISTOPHER RAIO111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTERNYEmergency Medicine Physician (207P00000X)
United
87272$7.191497944565 - MICHAEL SHULER581076549 - ATHENS ORTHOPEDIC CLINIC, PAGAOrthopaedic Hand Surgery Physician (207XS0106X)
United
87272$10.771629432869 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH OP SURGERY SPARTANBURG811723202 - PRISMA HEALTH - UPSTATESCGeneral Acute Care Hospital (282N00000X)
United
87272$11.981073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
87272$11.971467129700 - VHS SAN ANTONIO PARTNERS, LLC, NORTHEAST BAPTIST HOSPITAL760714523TXGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 87272 vs. Other Microbiology Procedures Codes

The CPT 87272 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 87272 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.

CodeComplexityDescription
87271-CPTLowInfectious Agent Antigen Detection By Immunofluorescent Technique; Cytomegalovirus, Direct Fluorescent Antibody (Dfa)
87272-CPTLowAntigen Detection By Fluorescent Antibody; Cryptosporidium/Giardia
87273-CPTLowAntigen Detection, Immunofluorescent Tech; Herpes Simplex Virus Type 2

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87272. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 87272 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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