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See a sample rate comparisonCPT 87540 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.
Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Legionella Pneumophila Direct Probe Techniq Ue Infectious Agent Detection By Nucleic Acid (Dna Or Rna)
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 26 - Professional component GW - Condition not related to the patient's terminal condition |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87540 |
| Medicaid Fee Schedule | View Medicaid rates for 87540 |
National average reimbursement for CPT 87540 by major payers:
$20.53
$14.69
$21.24
$29.12
Compare published rates across providers.
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CPT 87540
5 of 25 sample ratesHigher to lower in this preview
Restorative Health Rehabilitation Inc
$40.00Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$20.05Published ratePrisma Health-Upstate, Prisma Health Ctr For Ped & Int Med-West
Prisma Health - Upstate
$18.04Published rateBellville Hospital District, Bellville General Hospital
Bellville Medical Center
$11.77Published rateMatthew Lilley
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 87540 vs. Other Microbiology Procedures Codes
The CPT 87540 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 87540 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 |
|---|---|---|
| 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) |
| 87540-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Legionella Pneumophila Direct Probe Techniq Ue Infectious Agent Detection By Nucleic Acid (Dna Or Rna) |
| 87541-CPT | Low | Legionnaires Disease Test, This Test Detects Infection With Legionella A Gram Negative Bacteria Responsible For Legionnaires Disease. Testing Matches Bacteria Dna Or Rna. |
| 87542-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Legionella Pneumophila Quantification Infe Ctious Agent 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 87540. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87540 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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