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See a sample rate comparisonCPT 87380 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 Detection By Immunoassay Technique (Eg Enzyme Immunoassay [Eia] Enzyme- Linked Immunosorbent Assay [Elisa] Fluorescence Immunoassay [Fia] Immuno- Chemiluminometric Assay [Imca]) Qualitative Or Semiquantitative; Hepatitis Delta Agent (Desc Rvsd 10/6/20)
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87380 |
| Medicaid Fee Schedule | View Medicaid rates for 87380 |
National average reimbursement for CPT 87380 by major payers:
$17.89
$12.27
$19.85
$26.34
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CPT 87380
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$40.39Published rateEast Cooper Community Hospital, Inc., East Cooper Medical Center
$18.36Published ratePrisma Health-Upstate, Prisma Health Op Surgery Patewood
Prisma Health - Upstate
$16.52Published rateNevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
$9.63Published rateEthicus Hospital Dfw LLC, Legent Orthopedic Hospital
Ethicus Hospital Dfw
$7.71Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87380 vs. Other Microbiology Procedures Codes
The CPT 87380 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 87380 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 |
|---|---|---|
| 87350-CPT | Low | Infectious Agent Antigen Detection By Immunoassay Technique (Eg Enzyme Immunoassay [Eia] Enzyme- Linked Immunosorbent Assay [Elisa] Fluorescence Immunoassay [Fia] Immuno- Chemiluminometric Assay [Imca]) Qualitative Or Semiquantitative; Hepatitis Be Antigen (Hbeag) (Desc Rvsd 10/6/20) |
| 87380-CPT | Low | Infectious Agent Antigen Detection By Immunoassay Technique (Eg Enzyme Immunoassay [Eia] Enzyme- Linked Immunosorbent Assay [Elisa] Fluorescence Immunoassay [Fia] Immuno- Chemiluminometric Assay [Imca]) Qualitative Or Semiquantitative; Hepatitis Delta Agent (Desc Rvsd 10/6/20) |
| 87385-CPT | Low | Infectious Agent Antigen Detection By Immunoassay Technique (Eg Enzyme Immunoassay [Eia] Enzyme- Linked Immunosorbent Assay [Elisa] Fluorescence Immunoassay [Fia] Immuno- Chemiluminometric Assay [Imca]) Qualitative Or Semiquantitative; Histoplasma Capsulatum (Desc Rvsd 10/6/20) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87380. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87380 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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