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See a sample rate comparisonCPT 87513 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.
H Pylri Clrthmcn Rst Amp Prb, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Helicobacter Pylori (H. Pylori) Clarithromycin Resistance Amplified Probe Technique
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | $35.09 national lab fee schedule rate (2026) · View Medicare rates for 87513 |
| Medicaid Fee Schedule | $32.895 median of the 8 states in the free preview · View Medicaid rates for 87513 |
National average reimbursement for CPT 87513 by major payers:
$32.58
$35.03
$4.00
$646.67
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CPT 87513
5 of 25 sample ratesHigher to lower in this preview
Ahs Hospital Corp., Morristown Medical Center
Atlantic Health System Inc
$35.79Published rateTanner Medical Center, Inc, Tanner Health System
Tanner Medical Center Inc
$21.04Published rateThe Hospital Authority Of Monroe County, Georgia, Monroe County Hospital
The Hospital Authority Of Monroe County Georgia
$21.04Published rateAlicia Encinas
Miguel A Arenas Md PC
$14.73Published rateAnant Desai
Renal Consultants Medical Group
$14.73Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87513 vs. Other Microbiology Procedures Codes
The CPT 87513 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 87513 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 |
|---|---|---|
| 87513-CPT | Low | H Pylri Clrthmcn Rst Amp Prb, 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 87513. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87513 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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