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See a sample rate comparisonCPT 87537 is classified under Pathology and Laboratory Procedures, in the Microbiology Procedures subgroup.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 20 - Urgent Care Facility |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $21.92 national lab fee schedule rate (2026) · View Medicare rates for 87537 |
| Medicaid Fee Schedule | $20.165 median of the 8 states in the free preview · View Medicaid rates for 87537 |
National average reimbursement for CPT 87537 by major payers:

$21.93
BCBS / Anthem

$15.27
UnitedHealthcare

$23.44
Aetna

$32.37
Cigna
Choose a payer to see a sample of rates for CPT 87537.
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
Christopher Raio
Good Samaritan Hosptial Medical Center
Marc Stiefel
Pinnacle Ent Alliance, LLC
Christopher Raio
Mercy Medical Center
Molly Mcintosh
Baycare Medical Group Inc
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 87537 vs. Other Microbiology Procedures Codes
The table lists codes related to 87537. 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 87537. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87537 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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