CPT 87045

Across 114,970 services billed by 227 providers to 110,031 beneficiaries, Medicare allowed an average of $9.24 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.

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.

• 87086Bacterial colony count$7.90
• 87088Bacterial urine culture$7.92
• 87077Bacterial culture for aerobic isolates$7.91
• 87070Bacterial culture$8.44
• 87075Bacterial culture$9.27
• 87046Stool culture$9.24
• 87081Screening test for pathogenic organisms$6.49
• 87040Bacterial blood culture$10.09
• 87015Concentration of specimen for infectious agents$6.54
• 87076Bacterial culture for anaerobic isolates$7.91
• 87084Screening test for pathogenic organisms$26.42
• 87071Bacterial culture and colony count$9.67

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.

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