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See a sample rate comparisonCPT 89055 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.
Stool White Blood Cell Count, The Test Identifies White Blood Cells (Wbcs) In A Stool Sample. Presence Absence And Quantity Of Wbcs All Give Clues About What Is Causing Diarrhea.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Other Pathology and Laboratory Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 89055 |
| Medicaid Fee Schedule | View Medicaid rates for 89055 |
National average reimbursement for CPT 89055 by major payers:
$4.08
$3.99
$5.09
$6.32
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CPT 89055
5 of 25 sample ratesHigher to lower in this preview
Lubbock Heritage Hospital, LLC., Grace Surgical Hospital
Lubbock Heritage Hospital LLC
$7.15Published rateChildress County Hospital District, Childress Regional Medical Center
$5.11Published rateSpartanburg Medical Center
$4.26Published rateFairfield Hospital District, Freestone Medical Center
$3.63Published rateHospital Service District Of The Parish Of St. Bernard, State Of Louis, St. Bernard Parish Hospital
Hospital Service District Of The Parish Of St Bernard State Of Louis
$1.78Published rate
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See a sample payer proposalCPT 89055 vs. Other Other Pathology and Laboratory Procedures Codes
The CPT 89055 code is part of the Pathology and Laboratory Procedures services used for Other Pathology and Laboratory 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 89055 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 |
|---|---|---|
| 89050-CPT | Low | Analysis Of Body Fluid, This Analysis Usually Looks At Body Fluid From The Spine Or A Joint. Numbers Of Each Type Of Cell That Is Present Are Counted Often To Check For An Infection In The Area Near The Sample. |
| 89051-CPT | Low | Analysis Of Body Fluid, This Analysis Usually Looks At Body Fluid From The Spine Or A Joint. Numbers Of Each Type Of Cell That Is Present Are Counted Often To Check For An Infection In The Area Near The Sample. |
| 89055-CPT | Low | Stool White Blood Cell Count, The Test Identifies White Blood Cells (Wbcs) In A Stool Sample. Presence Absence And Quantity Of Wbcs All Give Clues About What Is Causing Diarrhea. |
| 89060-CPT | Low | Identify Crystals In Specimen, This Analysis Method Identifies Crystals In A Fluid Sample. The Sample Can Be Blood Urine Spinal Fluid Or Fluid Taken From A Site Such As A Swollen Joint. This Testing Method Identifies Conditions Such As Gout And Pseudogout. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 89055. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 89055 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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