How much does Medicare pay for CPT 86592?

Medicare allowed an average of $4.18 per service and paid $4.18 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $38.76, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 86592?

Syphilis detection test. It was billed 130,610 times to 118,659 Medicare beneficiaries by 202 providers in 2024.

Which specialty bills 86592 most?

Clinical Laboratory, with 129,949 services from 186 clinicians. Next are Infectious Disease, Pathology, Family Practice.

CPT 86592

Syphilis detection test

$4.18Medicare-allowed amount per service, averaged across 130,610 services

Providers submitted

$38.76

Asking price, not received

Medicare allowed

$4.18

The fee schedule figure

Medicare paid

$4.18

Balance is patient coinsurance

Providers submitted an average of $38.76 for this code and Medicare allowed $4.18 — 9.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $4.18 (100%); the rest is the patient’s coinsurance and deductible.

Services: 130,610
Beneficiaries: 118,659
Providers billing it: 202
Total allowed: $545,950

What Medicare pays for CPT 86592

Across 130,610 services billed by 202 providers to 118,659 beneficiaries, Medicare allowed an average of $4.18 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 86592

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	129,949	118,063	$4.18	186
Infectious Disease	197	167	$4.18	3
Pathology	191	188	$4.18	4
Family Practice	130	124	$4.15	2
Nurse Practitioner	72	48	$4.18	4
Neurology	40	40	$4.18	1
Internal Medicine	31	29	$4.18	2

86592 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New Jersey	31,828	$4.18	$4.18	17
Florida	19,372	$4.18	$4.18	22
North Carolina	17,679	$4.18	$4.18	7
Texas	15,230	$4.18	$4.18	14
Georgia	5,684	$4.18	$4.18	7
Alabama	4,840	$4.18	$4.18	5
New York	4,781	$4.18	$4.18	10
Ohio	4,681	$4.18	$4.18	8
California	3,508	$4.18	$4.18	12
Kansas	3,483	$4.18	$4.18	3
Massachusetts	3,442	$4.18	$4.18	4
Illinois	3,436	$4.18	$4.18	10
Maryland	2,738	$4.18	$4.18	4
Tennessee	1,855	$4.17	$4.18	4
Pennsylvania	1,601	$4.18	$4.18	10
Wisconsin	1,097	$4.10	$4.18	2
Oklahoma	990	$4.17	$4.18	4
Colorado	833	$4.16	$4.18	2
Louisiana	509	$4.18	$4.18	5
Michigan	407	$4.18	$4.18	7
South Carolina	387	$4.16	$4.18	4
Minnesota	335	$4.16	$4.18	3
Virginia	242	$4.18	$4.18	4
Puerto Rico	211	$4.06	$4.18	6
Indiana	198	$4.21	$4.18	3
U.S. Virgin Islands	184	$4.18	$4.18	3
Mississippi	163	$4.13	$4.18	2
Arkansas	144	$4.18	$4.18	1
West Virginia	108	$4.18	$4.18	1
Arizona	106	$4.18	$4.18	2
Hawaii	102	$4.18	$4.18	1
Connecticut	96	$4.18	$4.18	2
Rhode Island	69	$4.18	$4.18	2
Kentucky	52	$4.18	$4.18	3
Washington	51	$4.18	$4.18	1
Delaware	40	$4.18	$4.18	2
New Hampshire	40	$4.18	$4.18	1
Iowa	28	$4.18	$4.18	1
Oregon	24	$4.18	$4.18	1
Missouri	23	$4.18	$4.18	1
Nevada	13	$4.18	$4.18	1

Related codes

86596Measurement of voltage-gated calcium channel antibody$11.80
86593Syphilis test$4.31
86580Skin test for tuberculosis$9.98

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.