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See a sample rate comparisonCPT 87900 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.
Drug Resistance Testing, Analysis Of Drug Resistance To A Specific Virus. The Test Is Used To Determine The Effectiveness Of Select Medication Treatment For Hiv Or Other Viruses.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $130.35 national lab fee schedule rate (2026) · View Medicare rates for 87900 |
| Medicaid Fee Schedule | $129.045 median of the 8 states in the free preview · View Medicaid rates for 87900 |
National average reimbursement for CPT 87900 by major payers:
$112.43
$91.20
$136.01
$211.18
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CPT 87900
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$286.77Published rateAaron Askew
Praxis Health, P.C.
$143.39Published rateCatherine Lee
Columbus Arthritis Center
$112.01Published rateChristopher Raio
St Joseph Hospital
$78.21Published rateBrittany Ptachick
Hroa 401k Plan
$54.75Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87900 vs. Other Microbiology Procedures Codes
The CPT 87900 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 87900 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 |
|---|---|---|
| 87900-CPT | Low | Drug Resistance Testing, Analysis Of Drug Resistance To A Specific Virus. The Test Is Used To Determine The Effectiveness Of Select Medication Treatment For Hiv Or Other Viruses. |
| 87901-CPT | Moderate | Test Antiviral Drug Resistance, This Test Evaluates Whether Or How Much Resistance The Hiv Virus May Have Developed To One Or More Drugs Or Drug Combinations. |
| 87902-CPT | Moderate | Identify Hepatitis C Subtype, This Blood Test Identifies The Hcv Subtype Causing Hepatitis C Infection. It Also Assesses Disease Prognosis Likely Response To Therapy And The Source Of The Hcv Infection. |
| 87903-CPT | Moderate | Phenotype Dna Hiv W Culture, Infectious Agent Phenotype Analysis By Nucleic Acid Dna Or Rna With Drug Resistance Tissue Culture Analysis Hiv 1 First Through 10 Drugs Tested |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87900. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87900 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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