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See a sample rate comparisonCPT 87290 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.
Infectious Agent Antigen Detec, Infectious Agent Antigen Detection By Direct Fluorescentantibody Technique Varicella Zoster Virus Infectious Agent Antigen Detection By Direct Fluorescent
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | None 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87290 |
| Medicaid Fee Schedule | View Medicaid rates for 87290 |
National average reimbursement for CPT 87290 by major payers:
$12.79
$9.13
$14.44
$19.46
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CPT 87290
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$29.52Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$13.42Published ratePrisma Health-Upstate, Prisma Health Transplant Center
Prisma Health - Upstate
$12.07Published rateChristopher Raio
Mercy Medical Center
$7.25Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$4.69Published rate
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See a sample payer proposalCPT 87290 vs. Other Microbiology Procedures Codes
The CPT 87290 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 87290 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 |
|---|---|---|
| 87285-CPT | Low | Syphilis Testing, This Test Detects Antibodies To Syphilis A Bacterial Infection. It Is Frequently Spread By Sexual Contact. Blood Tests Screen For The Infection And Monitor Response To Treatment. |
| 87290-CPT | Low | Infectious Agent Antigen Detec, Infectious Agent Antigen Detection By Direct Fluorescentantibody Technique Varicella Zoster Virus Infectious Agent Antigen Detection By Direct Fluorescent |
| 87299-CPT | Low | Infectious Agent Antigen Detec, Infectious Agent Antigen Detection By Direct Fluorescentantibody Technique Not Otherwise Specified Infectious Agent Antigen Detection By Direct Fluo Rescent |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87290. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87290 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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