CPT 87480 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 • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • 90 - Reference Laboratory |
| Complexity Level | Low |
National average reimbursement for CPT 87480 by major payers:
$19.77
$14.72
$22.62
$29.69
| 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 87480 | ||||||
United | 87480 | $12.02 | 1548260482 - MAIN LINE PATHOLOGY ASSOCIATES, PC | 232786651 - (PA) MAIN LINE PATHOLOGY ASSOCIATES, P.C | PA | Clinical Pathology/Laboratory Medicine Physician (207ZP0105X) |
United | 87480 | $12.02 | 1548260482 - MAIN LINE PATHOLOGY ASSOCIATES, PC | 232786651 - (PA) MAIN LINE PATHOLOGY ASSOCIATES, P.C | PA | Clinical Pathology/Laboratory Medicine Physician (207ZP0105X) |
United | 87480 | $20.04 | 1609860360 - OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL, ASSUMPTION COMMUNITY HOSPITAL | 721495500 - (LA) OUR LADY OF THE LAKE ASSUMPTION COMMUNITY HOSPITAL INC | LA | Rural Acute Care Hospital (282NR1301X) |
United | 87480 | $25.21 | 1902469653 - CLHG-DEQUINCY, LLC | 364911029 - (LA) CLHGDEQUINCY LLC | LA | Critical Access Hospital (282NC0060X) |
United | 87480 | $20.04 | 1508810573 - BAY AREA HEALTHCARE GROUP, LTD., CORPUS CHRISTI MEDICAL CENTER | 752387418 | TX | General Acute Care Hospital (282N00000X) |
United | 87480 | $20.04 | 1063411767 - ESSENT PRMC LP, PARIS REGIONAL MEDICAL CENTER | 331073948 | TX | General Acute Care Hospital (282N00000X) |
United | 87480 | $20.04 | 1740450121 - HOUSTON NORTHWEST OPERATING COMPANY, LLC, HOUSTON NORTHWEST MEDICAL CENTER ACUTE | 261512163 | TX | General Acute Care Hospital (282N00000X) |
United | 87480 | $20.04 | 1659323772 - COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP, MEDICAL CITY FORT WORTH | 621682202 - (TX) COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 87480 | $8.42 | 1316505043 - ETHICUS HOSPITAL DFW LLC, LEGENT ORTHOPEDIC HOSPITAL | 263044485 - (TX) ETHICUS HOSPITAL DFW | TX | General Acute Care Hospital (282N00000X) |
United | 87480 | $25.55 | 1407947336 - CLHG-VILLE PLATTE LLC, MERCY REGIONAL MEDICAL CENTER | 824681222 | LA | General Acute Care Hospital (282N00000X) |
United | 87480 | $8.42 | 1407191984 - BSA HOSPITAL LLC | 900914340 | TX | General Acute Care Hospital (282N00000X) |
United | 87480 | $24.62 | 1497792527 - UNIVERSITY HEALTHCARE SYSTEM, L.C., TULANE LAKESIDE HOSPITAL | 621596506 | LA | General Acute Care Hospital (282N00000X) |
United | 87480 | $20.04 | 1821098286 - TOURO INFIRMARY | 720423659 - (LA) TOURO INFIRMARY | LA | General Acute Care Hospital (282N00000X) |
United | 87480 | $18.04 | 1083661409 - LALLIE KEMP MEDICAL CTR, LALLIE KEMP REGIONAL MEDICAL CENTER | 726000749 | LA | Critical Access Hospital (282NC0060X) |
United | 87480 | $20.04 | 1962455816 - CHCA CONROE LP, CONROE REGIONAL MEDICAL CENTER | 621801361 - (TX) CHCA CONROE LP | TX | 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 87480 vs. Other Microbiology Procedures Codes
The CPT 87480 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 87480 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 |
|---|---|---|
| 87476-CPT | Low | Nucleic Acid Detection; Borrelia Burgdorferi, By Amplified Probe |
| 87478-CPT | Low | Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Borrelia Miyamotoi, Amplified Probe Technique |
| 87480-CPT | Low | Nucleic Acid Detection; Candida Species, Direct Probe Technique |
| 87481-CPT | Low | Nucleic Acid Detection; Candida Species, Amplified Probe Technique |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87480. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87480 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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