CPT 87449 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Pathology and Laboratory Procedures • Microbiology Procedures |
| Common Place of Service | • 81 - Independent Laboratory • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • 90 - Reference Laboratory |
| Complexity Level | Low |
National average reimbursement for CPT 87449 by major payers:
$11.24
$8.63
$13.86
$18.00
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 87449 | ||||||
United | 87449 | $7.19 | 1548260482 - MAIN LINE PATHOLOGY ASSOCIATES, PC | 232786651 - (PA) MAIN LINE PATHOLOGY ASSOCIATES, P.C | PA | Clinical Pathology/Laboratory Medicine Physician (207ZP0105X) |
United | 87449 | $10.77 | 1134222565 - LAFAYETTE SURGICAL HOSPITAL LLC, LAFAYETTE SURGICAL SPECIALTY HOSPITAL | 900021727 - (LA) LAFAYETTE SURGICAL SPECIALTY HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 87449 | $11.97 | 1811942238 - KPH-CONSOLIDATION, INC., HCA HOUSTON HEALTHCARE NORTH CYPRESS A CAMPUS OF HCA HOUSTON HEALTHCAR | 621619857 | TX | General Acute Care Hospital (282N00000X) |
United | 87449 | $11.97 | 1598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 87449 | $11.97 | 1295723229 - ST FRANCIS MEDICAL CENTER, INC | 720408970 - (LA) ST FRANCIS MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | 87449 | $16.76 | 1275633604 - EL PASO VAMC | 742934770 | TX | General Acute Care Hospital (282N00000X) |
United | 87449 | $11.97 | 1396129201 - UNION MEDICAL CENTER, UNION MEDICAL CENTER | 474491361 | SC | General Acute Care Hospital (282N00000X) |
United | 87449 | $11.97 | 1528026267 - LONGVIEW MEDICAL CENTER LP, LONGVIEW REGIONAL MEDICAL CENTER | 621762420 | TX | General Acute Care Hospital (282N00000X) |
United | 87449 | $11.97 | 1598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 87449 | $4.30 | 1215996632 - PARK PLACE SURGERY CENTER, LLC, PARK PLACE SURGICAL HOSPITAL | 721404092 - (LA) PARK PLACE SURGICAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 87449 | $5.98 | 1336172105 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 756001743 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | TX | General Acute Care Hospital (282N00000X) |
United | 87449 | $22.20 | 1639263189 - LASALLE PARISH HOSPITAL SERVICE DIST NO1, HARDTNER MEDICAL CENTER | 720652984 - (LA) HARDTNER MEDICAL CENTER | LA | Critical Access Hospital (282NC0060X) |
United | 87449 | $7.03 | 1144227935 - CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE, TRINITY MEDICAL | 720578642 - (LA) RIVERLAND MEDICAL CENTER | LA | Critical Access Hospital (282NC0060X) |
United | 87449 | $10.31 | 1013068808 - ST HELENA PARISH HOSPITAL, ST HELENA PARISH HOSPITAL | 720627145 - (LA) ST HELENA PARISH HOSPITAL | LA | Critical Access Hospital (282NC0060X) |
United | 87449 | $11.97 | 1912943184 - WOMAN'S HOSPITAL FOUNDATION, WOMAN'S HOSPITAL | 720652905 - (LA) WOMANS HOSPITAL FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 87449 vs. Other Microbiology Procedures Codes
The CPT 87449 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 87449 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 | 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 87449. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87449 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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