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See a sample rate comparisonCPT 87468 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.
Test For Parasitic Infection, This Is A Test For Confirming Infection With Anaplasma Phagocytophilum A Parasitic Infection Commonly Transmitted Through Ticks.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87468 |
| Medicaid Fee Schedule | View Medicaid rates for 87468 |
National average reimbursement for CPT 87468 by major payers:
$31.94
$21.46
$36.47
$87.07
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CPT 87468
5 of 25 sample ratesHigher to lower in this preview
Hillary Bashaw
Neuroscience Group Of Northeast Wisconsin, S.C.
$86.43Published rateKelley Parnell
Neuroscience Group Of Northeast Wisconsin, S.C.
$86.43Published rateMaria Joseph
Neuroscience Group Of Northeast Wisconsin, S.C.
$86.43Published rateHillary Bashaw
Neuroscience Group Of Northeast Wisconsin, S.C.
$86.43Published rateSerge Lartchenko M.D., PLLC
Serge Lartchenko Md PLLC
$14.73Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87468 vs. Other Microbiology Procedures Codes
The CPT 87468 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 87468 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 |
|---|---|---|
| 87468-CPT | Low | Test For Parasitic Infection, This Is A Test For Confirming Infection With Anaplasma Phagocytophilum A Parasitic Infection Commonly Transmitted Through Ticks. |
| 87469-CPT | Low | Iadna Babesia Microti Amplified Probe Technique, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Babesia Microti Amplified Probe Technique |
| 87471-CPT | Low | Test For Cat-Scratch Disease, This Test Detects Current Or Past Bacterial Infection From Bartonella. The Most Common Infection Is Transmitted From A Cat Scratch Or Bite. Immune-Compromised People Can React More Severely To This Bacteria. |
| 87472-CPT | Low | Test For Cat-Scratch Disease, This Test Detects Current Or Past Bacterial Infection From Bartonella. The Most Common Infection Is Transmitted From A Cat Scratch Or Bite. Immune-Compromised People Can React More Severely To This Bacteria. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87468. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87468 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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