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See a sample rate comparisonCPT 87528 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 Herpes Simplex Virus, The Test Detects The Herpes Simplex Virus (Hsv). If Hsv Is Present It Is Identified As Type 1 Or Type 2. The Test Sample Can Be Blood Tissue Or Fluid From A Herpes Blister.
| 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 87528 |
| Medicaid Fee Schedule | View Medicaid rates for 87528 |
National average reimbursement for CPT 87528 by major payers:
$20.57
$14.69
$21.01
$29.15
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CPT 87528
5 of 25 sample ratesHigher to lower in this preview
All Ways Homecare Inc
$60.00Published ratePelham Medical Center
$20.04Published ratePrisma Health-Upstate, Prisma Health Ob/Gyn Clinic
Prisma Health - Upstate
$18.04Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$12.03Published rateAaron Askew
The Orthopedic And Neurosurgical Center Of The Cascades
$8.42Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87528 vs. Other Microbiology Procedures Codes
The CPT 87528 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 87528 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 |
|---|---|---|
| 87525-CPT | Low | Test For Hepatitis G Virus, Hepatitis G Is A Virus That Can Damage The Liver. This Blood Test Detects Hepatitis G Genetic Material. The Test Is Used To Verify A Current Infection Or Monitor Response To Treatment. |
| 87528-CPT | Low | Test For Herpes Simplex Virus, The Test Detects The Herpes Simplex Virus (Hsv). If Hsv Is Present It Is Identified As Type 1 Or Type 2. The Test Sample Can Be Blood Tissue Or Fluid From A Herpes Blister. |
| 87529-CPT | Low | Test For Herpes Simplex Virus, The Test Detects The Herpes Simplex Virus (Hsv). If Hsv Is Present It Is Identified As Type 1 Or Type 2. The Test Sample Can Be Blood Tissue Or Fluid From A Herpes Blister. |
| 87530-CPT | Low | Test For Herpes Simplex Virus, The Test Detects The Herpes Simplex Virus (Hsv). If Hsv Is Present It Is Identified As Type 1 Or Type 2. The Test Sample Can Be Blood Tissue Or Fluid From A Herpes Blister. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87528. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87528 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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