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See a sample rate comparisonCPT 87812 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.
Coronavirus And Flu Virus Test, This Test Checks For Covid-19 And Flu Viruses (Types A And B) Using A Nose Or Throat Swab And Looks For Specific Viral Antigen Related To Coronavirus (Covid-19) A Respiratory Virus And Viral Infection Of The Lungs That Causes Fever Cough And Muscle Aches.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87812 |
| Medicaid Fee Schedule | View Medicaid rates for 87812 |
National average reimbursement for CPT 87812 by major payers:
$41.96
$62.13
$107.77
$N/A
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CPT 87812
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See a sample payer proposalCPT 87812 vs. Other Microbiology Procedures Codes
The CPT 87812 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 87812 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 |
|---|---|---|
| 87812-CPT | Low | Coronavirus And Flu Virus Test, This Test Checks For Covid-19 And Flu Viruses (Types A And B) Using A Nose Or Throat Swab And Looks For Specific Viral Antigen Related To Coronavirus (Covid-19) A Respiratory Virus And Viral Infection Of The Lungs That Causes Fever Cough And Muscle Aches. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87812. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87812 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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