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See a sample rate comparisonCPT 87535 Fee Schedule
Medicare rates as of January 2026
CPT 87535 is classified under Pathology and Laboratory Procedures, in the Microbiology Procedures subgroup.
Hiv 1 Probe Reverse Trnscrpj, Infectious Agent Detection By Nucleic Acid Dna Or Rna Hiv 1 Amplified Probe Technique Includes Reverse Transcription When Performed
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 71 - Public Health Clinic |
| 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 87535 |
| Medicaid Fee Schedule | $32.28 median of the 8 states in the free preview · View Medicaid rates for 87535 |
National average reimbursement for CPT 87535 by major payers:
$33.38
BCBS / Anthem
$25.64
UnitedHealthcare
$39.92
Aetna
$52.07
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 87535.
CPT 87535
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$77.20Published rateChristopher Raio
Mercy Medical Center
$46.32Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Faris
Prisma Health - Upstate
$31.57Published rateMichael Shuler
Athens Orthopedic Clinic, P.A.
$21.05Published rateAaron Askew
The Orthopedic And Neurosurgical Center Of The Cascades
$14.74Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87535 vs. Other Microbiology Procedures Codes
The table lists codes related to 87535. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 87534-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Hiv-1 Direct Probe Technique Infectious Ag Ent Detection By Nucleic Acid (Dna Or Rna) |
| 87535-CPT | Low | Hiv 1 Probe Reverse Trnscrpj, Infectious Agent Detection By Nucleic Acid Dna Or Rna Hiv 1 Amplified Probe Technique Includes Reverse Transcription When Performed |
| 87536-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Hiv-1 Quantification Infectious Agent Dete Ction By Nucleic Acid (Dna Or Rna) |
| 87537-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Hiv-2 Direct Probe Technique Infectious Ag Ent Detection By Nucleic Acid (Dna Or Rna) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87535. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87535 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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