What is the standard insurance baseline for CPT 87427?

The standard insurance baseline reimbursement rate is $11.74. This represents the customary allowable amount established across standard fee schedules.

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CPT 87427Medical Service

Detection Test by Immunoassay Technique for Shiga-like Toxin Bacterial Toxin

Q: What do doctors typically charge for Detection Test by Immunoassay Technique for Shiga-like Toxin Bacterial Toxin?

The nationwide median physician charge for Detection Test by Immunoassay Technique for Shiga-like Toxin Bacterial Toxin (CPT 87427) is $59.58. Doctor billed charges vary based on geographic region, setting, and overhead.

Detection test by immunoassay technique for shiga-like toxin (bacterial toxin). Clinical pricing breakdown and utilization metrics across 127 practicing doctors nationwide.

$59.58

Peer Median Charge

Gross billed rate

$11.74

Standard Baseline

Customary allowable

5.1x

National Markup

Charge vs baseline

127

Active Physicians

Billing this code

Planning care or already received a bill for CPT 87427?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $59.58. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $11.74 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 87427 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"