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See a sample rate comparisonCPT 87520 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.
Test For Hepatitis C Virus, Hepatitis C Is A Virus That Can Damage The Liver. This Blood Test Detects Hepatitis C Genetic Material. The Test Is Used To Verify A Current Infection Or Monitor Response To Treatment Of A Chronic Infection.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | $31.22 national lab fee schedule rate (2026) · View Medicare rates for 87520 |
| Medicaid Fee Schedule | $27.82 median of the 8 states in the free preview · View Medicaid rates for 87520 |
National average reimbursement for CPT 87520 by major payers:
$28.04
$18.37
$29.79
$43.55
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CPT 87520
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$68.68Published rateUnion Medical Center, Union Medical Center
$31.21Published rateBradley Weisner
Urology Specialists Of The Carolinas, PLLC
$28.02Published rateChristopher Raio
St Joseph Hospital
$18.73Published rateMolly Mcintosh
Baycare Medical Group Inc
$7.34Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87520 vs. Other Microbiology Procedures Codes
The CPT 87520 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 87520 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 |
|---|---|---|
| 87520-CPT | Low | Test For Hepatitis C Virus, Hepatitis C Is A Virus That Can Damage The Liver. This Blood Test Detects Hepatitis C Genetic Material. The Test Is Used To Verify A Current Infection Or Monitor Response To Treatment Of A Chronic Infection. |
| 87521-CPT | Low | Test For Hepatitis C Virus, Hepatitis C Is A Virus That Can Damage The Liver. This Blood Test Detects Hepatitis C Genetic Material. The Test Is Used To Verify A Current Infection Or Monitor Response To Treatment Of A Chronic Infection. |
| 87522-CPT | Low | Test For Hepatitis C Virus, Hepatitis C Is A Virus That Can Damage The Liver. This Blood Test Detects Hepatitis C Genetic Material. The Test Is Used To Verify A Current Infection Or Monitor Response To Treatment Of A Chronic Infection. |
| 87523-CPT | Low | Test For Hepatitis D Virus, Hepatitis D Is A Virus That Can Damage The Liver. Testing Generally Is Limited To Individuals Who Carry Hepatitis B Or Those With Chronic Hepatitis B That Develop Complications. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87520 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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