CPT 87591 Fee Schedule
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.
| 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 • 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87591 |
National average reimbursement for CPT 87591 by major payers:
$32.22
$25.02
$41.61
$52.17
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 87591 | ||||||
United | 87591 | $29.14 | 1053303453 - STEPHEN EADLINE | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Pediatrics Physician (208000000X) |
United | 87591 | $14.73 | 1114914421 - UTE DREINER | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Rheumatology Physician (207RR0500X) |
United | 87591 | $14.73 | 1578874459 - ELAINE TSUKAYAMA | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Pediatrics Physician (208000000X) |
United | 87591 | $14.73 | 1356339592 - WADE HUNT | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Medicine Physician (207Q00000X) |
United | 87591 | $29.14 | 1629738422 - KASSANDRA GIGLIO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 87591 | $14.73 | 1861456444 - SCOTT PEPLINSKI | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 87591 | $40.34 | 1295729143 - SYED ZAMAN | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Anatomic Pathology & Clinical Pathology Physician (207ZP0102X) |
United | 87591 | $14.73 | 1063106441 - ANDREA MOEHRINGER | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 87591 | $29.14 | 1548256399 - NIRANJAN SELVARAJAH | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Medicine Physician (207Q00000X) |
United | 87591 | $14.73 | 1578874459 - ELAINE TSUKAYAMA | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Pediatrics Physician (208000000X) |
United | 87591 | $14.73 | 1972938900 - JEFFREY KWASNIEWSKI | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 87591 | $29.14 | 1982313656 - GABRIELLA PLADOCOSTANTE | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 87591 | $29.14 | 1285625996 - SLOCUM DICKSON MEDICAL GROUP PLLC | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Clinic/Center (261Q00000X) |
United | 87591 | $29.14 | 1134110281 - NAJMUS SAQIB | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 87591 | $20.60 | 1144227935 - CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE, TRINITY MEDICAL | 720578642 - (LA) RIVERLAND MEDICAL CENTER | LA | Critical Access Hospital (282NC0060X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 87591 vs. Other Microbiology Procedures Codes
The CPT 87591 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 87591 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 |
|---|---|---|
| 87533-CPT | Low | Nucleic Acid Detection; Herpes Virus-6, Quantification |
| 87534-CPT | Low | Nucleic Acid Detection; Hiv-1, Direct Probe Technique |
| 87535-CPT | Low | Infectious Agent Detection By Nucleic Acid (Dna Orrna); Hiv-1 Amplified Probe Technique Includes Reverse Transcription When Performed (Revised 01/01/2014) |
| 87591-CPT | Low | Nucleic Acid Detection; Neisseria Gonorrhoeae, By Amplified Probe |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87591. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87591 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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