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See a sample rate comparisonCPT 87581 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.
Infect Agnt Detect By Nucleic Acid (Dna Or Rna); Mycoplasma Pn, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Mycoplasma Pn
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87581 |
| Medicaid Fee Schedule | View Medicaid rates for 87581 |
National average reimbursement for CPT 87581 by major payers:
$32.70
$25.23
$37.49
$50.89
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CPT 87581
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$77.20Published rateRestorative Health Rehabilitation Inc
$40.00Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Easley
Prisma Health - Upstate
$31.57Published rateNicole Schwab
Allergy & Asthma Of Dupage, S.C.
$28.07Published rateBsa Hospital LLC
$14.73Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87581 vs. Other Microbiology Procedures Codes
The CPT 87581 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 87581 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) |
| 87580-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Mycoplasma Pneumoniae Direct Probe Techniqu E Infectious Agent Detection By Nucleic Acid (Dnaor Rna) |
| 87581-CPT | Low | Infect Agnt Detect By Nucleic Acid (Dna Or Rna); Mycoplasma Pn, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Mycoplasma Pn |
| 87582-CPT | Moderate | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Mycoplasma Pneumoniae Quantification Infec Tious 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 87581. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87581 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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