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See a sample rate comparisonCPT 87591 Fee Schedule
Medicare rates as of January 2026
CPT 87591 is classified under Pathology and Laboratory Procedures, in the Microbiology Procedures subgroup.
Infect Agnt Detect By Nucleic Acid (Dna Or Rna); Neisseria Gon, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Neisseria Gon
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | $35.09 national lab fee schedule rate (2026) · View Medicare rates for 87591 |
| Medicaid Fee Schedule | $34.65 median of the 8 states in the free preview · View Medicaid rates for 87591 |
National average reimbursement for CPT 87591 by major payers:
$32.22
BCBS / Anthem
$25.02
UnitedHealthcare
$41.61
Aetna
$50.97
Cigna
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CPT 87591
5 of 25 sample ratesHigher to lower in this preview
Syed Zaman
Slocum Dickson Medical Group PLLC
$40.34Published rateSlocum Dickson Medical Group PLLC
$29.14Published rateCarly Zegarelli
Slocum Dickson Medical Group PLLC
$29.14Published rateScott Peplinski
Slocum Dickson Medical Group PLLC
$14.73Published rateGabriella Pladocostante
Slocum Dickson Medical Group PLLC
$14.73Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87591 vs. Other Microbiology Procedures Codes
The table lists codes related to 87591. Select one to see its fee schedule.
| 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) |
| 87590-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Neisseria Gonorrhoeae Direct Probe Techniqu E Infectious Agent Detection By Nucleic Acid (Dnaor Rna) |
| 87591-CPT | Low | Infect Agnt Detect By Nucleic Acid (Dna Or Rna); Neisseria Gon, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Neisseria Gon |
| 87592-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Neisseria Gonorrhoeae 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 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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Frequently Asked Questions
To find out the cost of a specific medical procedure, you'll need to know the CPT (Current Procedural Terminology) code and your specific location. For accurate and specific pricing information, you can use tools like Payerprice's fee schedule lookup, which allows you to search with a CPT code and location to get relevant fee schedule data.
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to describe medical, surgical, and diagnostic services. It's crucial for understanding healthcare costs because it standardizes the identification of services, allowing you to look up the specific price for a given procedure. Knowing the CPT code enables you to use tools like Payerprice to find fee schedules and understand what you might pay.
Healthcare costs can vary significantly due to several factors, including the type of service, the provider (e.g., hospital vs. independent clinic), geographic location, insurance company negotiations, and whether the service is in-network or out-of-network. Different payers (insurance companies) negotiate different rates with providers, leading to a wide range of prices for the same service.
Fee schedules for medical services are often specific to insurance plans, providers, and locations. While some general information might be publicly available, for precise and current fee schedule data tailored to your situation (e.g., CPT code and specific location), you should use a dedicated lookup tool. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your location to find relevant pricing information.
The 'billed charge' is the initial amount that a healthcare provider charges for a service, often its list price. The 'negotiated rate' (or allowed amount) is the amount that your health insurance company has agreed to pay the provider for that service. This rate is typically lower than the billed charge. Your out-of-pocket costs (copay, deductible, coinsurance) are usually based on the negotiated rate, not the billed charge.