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See a sample rate comparisonCPT 87556 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)Mycobacteria Tuberculosis Amplified Probe T Echnique
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 90 - Reference Laboratory 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87556 |
| Medicaid Fee Schedule | View Medicaid rates for 87556 |
National average reimbursement for CPT 87556 by major payers:
$37.78
$27.30
$41.73
$59.26
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CPT 87556
5 of 25 sample ratesHigher to lower in this preview
St. Luke'S Community Health Services, St. Luke'S The Woodlands Hospital
St Lukes Community Health Services
$65.00Published rateChristopher Raio
St Joseph Hospital
$48.09Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Easley
Prisma Health - Upstate
$37.50Published rateChristopher Raio
Mercy Medical Center
$25.01Published rateBrittany Ptachick
Hroa 401k Plan
$17.51Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87556 vs. Other Microbiology Procedures Codes
The CPT 87556 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 87556 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 |
|---|---|---|
| 87550-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Mycobacteria Species Direct Probe Technique Infectious Agent Detection By Nucleic Acid (Dna Or Rna) |
| 87555-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Mycobacteria Tuberculosis Direct Probe Tech Nique Infectious Agent Detection By Nucleic Acid (Dna Or Rna) |
| 87556-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Mycobacteria Tuberculosis Amplified Probe T Echnique |
| 87557-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Mycobacteria Tuberculosis Quantification I Nfectious 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 87556. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87556 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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