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See a sample rate comparisonCPT 87491 Fee Schedule
Medicare rates as of January 2026
CPT 87491 is classified under Pathology and Laboratory Procedures, in the Microbiology Procedures subgroup.
Test To Confirm Chlamydia, This Is A Test For Confirming Infection With Chlamydia Trachomatis Commonly Transmitted Through Sexual Contact. The Sample Tested May Be Taken From The Cervix Urethra Or Urine.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $35.09 national lab fee schedule rate (2026) · View Medicare rates for 87491 |
| Medicaid Fee Schedule | $34.65 median of the 8 states in the free preview · View Medicaid rates for 87491 |
National average reimbursement for CPT 87491 by major payers:
$32.07
BCBS / Anthem
$25.09
UnitedHealthcare
$41.98
Aetna
$88.29
Cigna
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CPT 87491
5 of 25 sample ratesHigher to lower in this preview
Hunt Memorial Hospital District, Hunt Regional
Hunt Memorial Hospital District
$57.88Published rateAthens Hospital, LLC
$35.09Published rateKassandra Giglio
Slocum Dickson Medical Group PLLC
$29.14Published rateEastland Memorial Hospital District, Eastland Memorial Hospital
$14.73Published rateHaifa Jaedi
Siskiyou Pediatric Clinic LLP
$14.73Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87491 vs. Other Microbiology Procedures Codes
The table lists codes related to 87491. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 87485-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Chlamydia Pneumoniae Direct Probe Technique Infectious Agent Detection By Nucleic Acid (Dna Or Rna) |
| 87490-CPT | Low | Test To Confirm Chlamydia, This Is A Test For Confirming Infection With Chlamydia Trachomatis Commonly Transmitted Through Sexual Contact. The Sample Tested May Be Taken From The Cervix Urethra Or Urine. |
| 87491-CPT | Low | Test To Confirm Chlamydia, This Is A Test For Confirming Infection With Chlamydia Trachomatis Commonly Transmitted Through Sexual Contact. The Sample Tested May Be Taken From The Cervix Urethra Or Urine. |
| 87492-CPT | Low | Test To Confirm Chlamydia, This Is A Test For Confirming Infection With Chlamydia Trachomatis Commonly Transmitted Through Sexual Contact. The Sample Tested May Be Taken From The Cervix Urethra Or Urine. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87491. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87491 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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