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CPT 87563 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) Mycoplasma Genitalium Amplified Probe Tech Nique
Key FactDetail
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 LevelLow
Medicare Fee ScheduleView Medicare rates for 87563
Medicaid Fee ScheduleView Medicaid rates for 87563

National average reimbursement for CPT 87563 by major payers:

bcbs

$30.11

uhc

$21.81

aetna

$34.14

cigna

$71.69

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 87563.

CPT 87563
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $77.20Published rate
  2. Mary Harris

    Atlantic Health System Inc

    NJInternal Medicine PhysicianNPI 1487626370Tax ID 52-1958352

    $45.54Published rate
  3. Christopher Raio

    St Joseph Hospital

    NYEmergency Medicine PhysicianNPI 1255478004Tax ID 11-3438973

    $21.05Published rate
  4. Aaron Askew

    The Orthopedic And Neurosurgical Center Of The Cascades

    OROrthopaedic Trauma PhysicianNPI 1366428401Tax ID 93-1261079

    $14.74Published rate
  5. E And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go

    E And A Medical On The Go Healthcare Of South Florida LLC

    FLHome Health AgencyNPI 1598375651Tax ID 83-2289173

    $12.27Published rate

National sample. Rates vary by location, specialty, and contract.

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CPT 87563 vs. Other Microbiology Procedures Codes

The CPT 87563 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 87563 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.

CodeComplexityDescription
87534-CPTLowInfectious 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-CPTLowHiv 1 Probe Reverse Trnscrpj, Infectious Agent Detection By Nucleic Acid Dna Or Rna Hiv 1 Amplified Probe Technique Includes Reverse Transcription When Performed
87536-CPTLowInfectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Hiv-1 Quantification Infectious Agent Dete Ction By Nucleic Acid (Dna Or Rna)
87563-CPTLowInfectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna) Mycoplasma Genitalium Amplified Probe Tech Nique

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87563. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 87563 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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