Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 87640 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.
Test For Staph Infection, The Test Detects Staphylococcus Aureus As The Source Of An Infection. This Bacteria Can Cause Many Different Types Of Infections Including Skin Infections Cellulitis Pneumonia And Bone/Joint Infections.
| 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 87640 |
| Medicaid Fee Schedule | View Medicaid rates for 87640 |
National average reimbursement for CPT 87640 by major payers:
$32.46
$24.93
$39.11
$75.04
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 87640.
CPT 87640
5 of 25 sample ratesHigher to lower in this preview
Mary Harris
Atlantic Health System Inc
$52.11Published rateBay Area Healthcare Group, Ltd., Corpus Christi Medical Center
$35.09Published rateThe Medical Center Of Southeast Texas Lp
$35.09Published ratePrisma Health-Upstate, Prisma Health Hillcrest Hospital Vascular Lab
Prisma Health - Upstate
$31.57Published rateChristus Health Ark-La-Tex, Christus St. Michael Health System
Christus Health Arklatex
$14.73Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 87640 vs. Other Microbiology Procedures Codes
The CPT 87640 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 87640 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) |
| 87535-CPT | Low | Hiv 1 Probe Reverse Trnscrpj, Infectious Agent Detection By Nucleic Acid Dna Or Rna Hiv 1 Amplified Probe Technique Includes Reverse Transcription When Performed |
| 87640-CPT | Low | Test For Staph Infection, The Test Detects Staphylococcus Aureus As The Source Of An Infection. This Bacteria Can Cause Many Different Types Of Infections Including Skin Infections Cellulitis Pneumonia And Bone/Joint Infections. |
| 87641-CPT | Low | Antibiotic Resistance Test, The Test Detects Methicillin-Resistant Staphylococcus Aureus (Mrsa) As The Source Of An Infection. This Bacteria Is Resistant To Many Commonly Used Antibiotics And Can Cause Many Different Type Of Infections. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87640. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87640 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 87640) and we'll show you how you compare in 15 minutes or less.