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See a sample rate comparisonCPT 87807 Fee Schedule
Last Verified: October 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.
Infectious Agent Antigen Detec, Infectious Agent Antigen Detection By Immunoassay With Direct Optical (Ie Visual) Observation Respiratory Syncytial Virus
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | None QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87807 |
| Medicaid Fee Schedule | View Medicaid rates for 87807 |
National average reimbursement for CPT 87807 by major payers:
$11.87
$9.14
$14.97
$44.13
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CPT 87807
5 of 25 sample ratesHigher to lower in this preview
St. James Parish Hosp. Serv. Dist.
St James Parish Hospital
$16.44Published rateUs Health Partners, LLC
Us Health Partners LLC
$13.10Published rateChca Pearland, L.P., Hca Houston Healthcare Pearland
$13.10Published rateChristus Health Ark-La-Tex, Christus St. Michael Health System
Christus Trinity Clinic
$7.86Published ratePark Place Surgery Center, LLC, Park Place Surgical Hospital
Park Place Surgical Hospital
$4.71Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87807 vs. Other Microbiology Procedures Codes
The CPT 87807 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 87807 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 |
|---|---|---|
| 87804-CPT | Low | Test For Flu Virus, Influenza (Flu) Is A Viral Infection Of The Lungs That Causes Fever Cough And Muscle Aches. The Test Checks A Sample From The Nose Or Throat For Influenza A B Or Both Types. |
| 87806-CPT | Low | Hiv Ag W Hiv1 2 Antb W Optic, Infectious Agent Antigen Detection By Immunoassay With Direct Optical Ie Visual Observation Hiv 1 Antigen S With Hiv 1 And Hiv 2 Antibodies |
| 87807-CPT | Low | Infectious Agent Antigen Detec, Infectious Agent Antigen Detection By Immunoassay With Direct Optical (Ie Visual) Observation Respiratory Syncytial Virus |
| 87811-CPT | Low | Infectious Agent Antigen Detec, Infectious Agent Antigen Detection By Immunoassay With Direct Optical (Ie Visual) Observation Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) (Coronavirus Disease [Covid-19]) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87807. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87807 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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