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See a sample rate comparisonCPT 87651 Fee Schedule
Medicare rates as of January 2026
CPT 87651 is classified under Pathology and Laboratory Procedures, in the Microbiology Procedures subgroup.
Infect Agnt Detect By Nucleic Acid (Dna Or Rna); Streptococcus, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Streptococcus
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 11 - Office 81 - Independent Laboratory |
| Common Modifiers | QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $35.09 national lab fee schedule rate (2026) · View Medicare rates for 87651 |
| Medicaid Fee Schedule | $32.28 median of the 8 states in the free preview · View Medicaid rates for 87651 |
National average reimbursement for CPT 87651 by major payers:
$31.68
BCBS / Anthem
$32.33
UnitedHealthcare
$43.06
Aetna
$51.20
Cigna
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CPT 87651
5 of 25 sample ratesHigher to lower in this preview
Elizabeth Westen
Slocum Dickson Medical Group PLLC
$34.04Published rateJessica Brutsky
Slocum Dickson Medical Group PLLC
$34.04Published rateShannon Lee
Slocum Dickson Medical Group PLLC
$34.04Published rateTaryn Rio
Slocum Dickson Medical Group PLLC
$21.04Published rateCelesta Hunsiker
Slocum Dickson Medical Group PLLC
$21.04Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87651 vs. Other Microbiology Procedures Codes
The table lists codes related to 87651. 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) |
| 87650-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Streptococcus Group A Direct Probe Techniq Ue Infectious Agent Detection By Nucleic Acid (Dna Or Rna) |
| 87651-CPT | Low | Infect Agnt Detect By Nucleic Acid (Dna Or Rna); Streptococcus, Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Streptococcus |
| 87652-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna)Streptococcus Group A Quantification Infe Ctious 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 87651. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87651 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
A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are essential for accurate billing and to ensure consistent reporting of procedures and services to insurance companies.
The cost of medical procedures can vary widely based on your location, healthcare provider, and insurance plan. For specific pricing information, you can often contact your healthcare provider's billing department, your insurance company, or utilize online tools designed for price transparency. For a detailed lookup of fee schedules based on CPT code and specific location, you can use tools like Payerprice.
Medical costs can vary significantly due to several factors, including the type of facility (e.g., hospital vs. outpatient clinic), geographic location, the specific insurance plan and its negotiated rates with providers, the complexity of the procedure, and whether the provider is in-network or out-of-network.
A fee schedule is a comprehensive listing of fees used by health insurers and government payers to reimburse providers. It specifies the maximum amount that will be paid for a particular procedure or service. These schedules are often organized by CPT codes.
To find the cost associated with a specific CPT code for your location, you can utilize specialized fee schedule lookup tools. Payerprice offers a tool that allows users to search for pricing information using CPT codes and specific geographical locations, helping you understand potential costs for medical services.