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See a sample rate comparisonCPT 87451 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; Polyvalent For Multiple Organisms Each Polyvalent Antiserum (Desc Rvsd 10/6/20)
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 20 - Urgent Care Facility |
| Common Modifiers | None 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87451 |
| Medicaid Fee Schedule | View Medicaid rates for 87451 |
National average reimbursement for CPT 87451 by major payers:
$9.39
$7.21
$11.12
$15.44
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CPT 87451
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$60.00Published rateChristopher Raio
Mercy Medical Center
$11.07Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Greer
Prisma Health - Upstate
$9.46Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$6.31Published 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
$3.68Published rate
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See a sample payer proposalCPT 87451 vs. Other Microbiology Procedures Codes
The CPT 87451 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 87451 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 87451. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87451 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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