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See a sample rate comparisonCPT 87472 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 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.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 11 - Office 19 - Off Campus Outpatient Hospital 23 - Emergency Room |
| Common Modifiers | None 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87472 |
| Medicaid Fee Schedule | View Medicaid rates for 87472 |
National average reimbursement for CPT 87472 by major payers:
$42.88
$30.95
$46.85
$61.98
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CPT 87472
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$94.25Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$42.84Published ratePrisma Health-Upstate, Prisma Health Ob/Gyn Clinic
Prisma Health - Upstate
$38.56Published rateChristopher Raio
Mercy Medical Center
$25.70Published rateGraham Regional Medical Center, Graham General Hsopital Physicians
$17.98Published rate
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See a sample payer proposalCPT 87472 vs. Other Microbiology Procedures Codes
The CPT 87472 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 87472 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 87472. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87472 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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