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See a sample rate comparisonCPT 87430 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; Streptococcus Group A (Desc Rvsd 10/6/20)
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | None QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87430 |
| Medicaid Fee Schedule | View Medicaid rates for 87430 |
National average reimbursement for CPT 87430 by major payers:
$13.78
$10.21
$16.63
$23.48
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CPT 87430
5 of 25 sample ratesHigher to lower in this preview
Lasalle Parish Hospital Service Dist No1, Hardtner Medical Center
Hardtner Medical Center
$25.21Published rateSpringhill Medical Services, Inc., Springhill Medical Center
Springhill Medical Services Inc
$16.80Published ratePrisma Health-Upstate, Prisma Health Ob/Gyn Clinic
Prisma Health - Upstate
$15.13Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$11.98Published rateUhs Of Texoma, Inc, Texoma Medical Center
Uhs Of Texoma Inc
$6.84Published rate
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See a sample payer proposalCPT 87430 vs. Other Microbiology Procedures Codes
The CPT 87430 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 87430 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 |
|---|---|---|
| 87430-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; Streptococcus Group A (Desc Rvsd 10/6/20) |
| 87449-CPT | Low | Infectious Agent Antigen Detection By Immunoassa Technique (Eg Enzyme Immunoassay [Eia] Enzyme Linked Immunosorbent Assay [Elisa] Fluorescence Immunoassay [Fia] Immuno- Chemiluminometric Assay [Imca]) Qualitative Or Semiquantitative; Not Otherwise Specified Each Organism (Desc Rvsd 10/6/20) |
| 87451-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; Polyvalent For Multiple Organisms Each Polyvalent Antiserum (Desc Rvsd 10/6/20) |
| 87467-CPT | Low | Hepatitis B Surface Ag Quan, Infectious Agent Antigen Detection By Immunoassay Technique Eg Enzyme Immunoassay Eia Enzyme Linked Immunosorbent Assay Elisa Fluorescence Immunoassay Fia Immunochemiluminometric Assay Imca Qualitative Or Semiquantitative Hepatitis B Surface Antigen Hbsag Quantitative |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87430. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87430 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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