CPT 87510 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 |
| Medicare Fee Schedule | View Medicare rates for 87510 |
National average reimbursement for CPT 87510 by major payers:
$19.77
$14.73
$22.55
$29.68
| 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 87510 | ||||||
United | 87510 | $33.61 | 1972517365 - COVENANT MEDICAL CENTER | 822913146 - (TX) COVENANT MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $20.04 | 1023065794 - CHCA WOMANS HOSPITAL LP, WOMAN'S HOSPITAL OF TEXAS | 621810381 - (TX) CHCA WOMANS HOSPITAL LP | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $20.04 | 1972709970 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE EAST CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $20.04 | 1255384533 - COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP, MEDICAL CITY LEWISVILLE | 621682210 - (TX) DE MARKETING AND SALES | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $24.62 | 1104819366 - CHILDREN'S HOSPITAL | 720467503 - CHILDRENS HOSPITAL INC | LA | Children's Hospital (282NC2000X) |
United | 87510 | $20.04 | 1861994808 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE NORTHEAST CAMPUS | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $37.13 | 1942208616 - ST. LUKE'S COMMUNITY HEALTH SERVICES, ST. LUKE'S THE WOODLANDS HOSPITAL | 760536234 - (TX) ST LUKES COMMUNITY HEALTH SERVICES | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $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 | 87510 | $20.04 | 1063466035 - CHCA CLEAR LAKE LP, HCA HOUSTON HEALTHCARE CLEAR LAKE | 621801360 | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $20.04 | 1528027786 - METHODIST HOSPITALS OF DALLAS, METHODIST DALLAS MEDICAL CENTER | 750800661 - METHODIST HOSPITALS OF DALLAS | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $24.05 | 1174526529 - TITUS COUNTY HOSPITAL DISTRICT, TITUS REGIONAL MEDICAL CENTER | 756003935 | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $16.80 | 1972590602 - PALO PINTO COUNTY HOSPITAL DISTRICT, PALO PINTO GENERAL HOSPITAL | 751256948 | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $8.42 | 1407191984 - BSA HOSPITAL LLC | 300754305 | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $20.04 | 1134172406 - COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP, MEDICAL CITY ARLINGTON | 621682201 - COLUMBIA MEDICAL CENTER OF ARLINGTON SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 87510 | $28.02 | 1275633604 - EL PASO VAMC | 742934770 | 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 87510 vs. Other Microbiology Procedures Codes
The CPT 87510 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 87510 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 |
|---|---|---|
| 87510-CPT | Low | Nucleic Acid Detection; Gardnerella Vaginalis, Direct Probe Technique |
| 87511-CPT | Low | Nucleic Acid Detection; Gardnerella Vaginalis, By Amplified Probe |
| 87512-CPT | Low | Nucleic Acid Detection; Gardnerella Vaginalis, Quantification |
| 87513-CPT | Moderate | Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Helicobacter Pylori (H. Pylori), Clarithromycin Resistance, 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 87510. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87510 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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