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See a sample rate comparisonCPT 87481 Fee Schedule
Last Verified: September 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 Candida Infection, Candida Albicans Is A Type Of Yeast That Is A Common Cause Of Infections. A Blood Test To Detect Candida Is Used To Diagnose Widespread Infections.
| 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 87481 |
| Medicaid Fee Schedule | View Medicaid rates for 87481 |
National average reimbursement for CPT 87481 by major payers:
$32.84
$25.23
$40.27
$51.29
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CPT 87481
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
Mercy Medical Center
$66.86Published rateWaccamaw Community Hospital, Tidelands Waccamaw Community Hospital
Waccamaw Community Hospital
$35.09Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Grove
Prisma Health - Upstate
$31.57Published rateMichael Shuler
Athens Orthopedic Clinic, P.A.
$21.05Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$17.13Published rate
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See a sample payer proposalCPT 87481 vs. Other Microbiology Procedures Codes
The CPT 87481 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 87481 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 | Test For Lyme Disease, Lyme Disease Is Caused By Borrelia Burgdorferi And This Test Detects Antibodies Produced In Response. A Follow-Up Test Confirms A Positive Result. The Test Sample May Be Spinal Fluid Blood Or Urine. |
| 87480-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Candida Species Direct Probe Technique Inf Ectious Agent Detection By Nucleic Acid (Dna Or Rna) |
| 87481-CPT | Low | Test For Candida Infection, Candida Albicans Is A Type Of Yeast That Is A Common Cause Of Infections. A Blood Test To Detect Candida Is Used To Diagnose Widespread Infections. |
| 87482-CPT | Low | Test For Candida Infection, Candida Albicans Is A Type Of Yeast That Is A Common Cause Of Infections. A Blood Test To Detect Candida Is Used To Diagnose Widespread Infections. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87481. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87481 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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