How much does Medicare pay for CPT 86677?

Medicare allowed an average of $16.50 per service and paid $16.50 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $31.11, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 86677?

Analysis for antibody to helicobacter pylori (gastrointestinal bacteria). It was billed 31,546 times to 23,082 Medicare beneficiaries by 114 providers in 2024.

Does 86677 pay differently in an office than a hospital?

Yes. The allowed amount averaged $16.50 in an office setting and $16.51 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 86677 most?

Clinical Laboratory, with 30,648 services from 75 clinicians. Next are Family Practice, Gastroenterology, Internal Medicine.

CPT 86677

Analysis for antibody to helicobacter pylori (gastrointestinal bacteria)

$16.50Medicare-allowed amount per service, averaged across 31,546 services

Providers submitted

$31.11

Asking price, not received

Medicare allowed

$16.50

The fee schedule figure

Medicare paid

$16.50

Balance is patient coinsurance

Providers submitted an average of $31.11 for this code and Medicare allowed $16.50 — 1.9× 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 $16.50 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $16.50
Hospital / facility: $16.51

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 31,535 services were billed in an office setting and 11 in a facility.

Services: 31,546
Beneficiaries: 23,082
Providers billing it: 114
Total allowed: $520,509

What Medicare pays for CPT 86677

Across 31,546 services billed by 114 providers to 23,082 beneficiaries, Medicare allowed an average of $16.50 per service. That is 1.4 services per beneficiary, so this is a code patients typically receive more than once. 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 86677

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	30,648	22,206	$16.50	75
Family Practice	351	341	$16.51	16
Gastroenterology	214	207	$16.43	6
Internal Medicine	104	102	$16.27	6
Nurse Practitioner	81	81	$16.33	5
Cardiology	67	65	$16.51	1
General Surgery	36	35	$16.15	2
Physician Assistant	19	19	$16.51	1
General Practice	15	15	$16.51	1
Pathology	11	11	$16.51	1

86677 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
California	24,598	$16.51	$16.51	35
New Jersey	3,602	$16.49	$16.51	4
Illinois	481	$16.51	$16.51	7
Florida	402	$16.49	$16.51	7
Tennessee	352	$16.47	$16.51	2
Pennsylvania	329	$16.51	$16.51	1
Texas	279	$16.37	$16.51	7
Oklahoma	149	$16.41	$16.51	2
Arkansas	130	$16.41	$16.51	8
New York	127	$16.51	$16.51	2
Wisconsin	126	$16.38	$16.51	1
Alabama	118	$16.22	$16.51	8
Missouri	95	$16.51	$16.51	3
Mississippi	87	$16.51	$16.51	5
Virginia	74	$16.32	$16.51	3
Kentucky	73	$16.51	$16.51	2
Michigan	72	$16.28	$16.51	1
Indiana	71	$16.51	$16.51	1
South Carolina	67	$16.51	$16.51	3
Hawaii	67	$16.51	$16.51	1
Kansas	56	$16.51	$16.51	2
Massachusetts	56	$16.51	$16.51	3
Ohio	53	$16.51	$16.51	1
Oregon	30	$16.51	$16.51	1
Puerto Rico	16	$15.69	$16.51	1
New Mexico	13	$16.51	$16.51	1
Washington	12	$16.51	$16.51	1
Colorado	11	$13.51	$16.51	1

Related codes

86618Analysis for antibody borrelia burgdorferi (lyme disease bacteria)$16.68
86617Confirmation test for antibody to borrelia burgdorferi (lyme disease b$15.17
86635Analysis for antibody to coccidioides (bacteria)$11.21
86666Analysis for antibody to ehrlichia (bacteria transmitted by ticks)$9.97
86665Analysis for antibody to epstein-barr virus (mononucleosis virus)$17.75
86609Analysis for antibody bacteria$12.54
86684Analysis for antibody to haemophilus influenza (respiratory bacteria)$15.52
86664Analysis for antibody to epstein-barr virus (mononucleosis virus)$14.96
86696Analysis for antibody to herpes simplex virus$18.92
86695Analysis for antibody to herpes simplex virus$12.91
86671Analysis for antibody to fungus$11.99
86606Analysis for antibody to aspergillus (fungus)$14.64

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.