How much does Medicare pay for CPT 87088?

Medicare allowed an average of $7.92 per service and paid $7.92 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $31.23, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87088?

Bacterial urine culture. It was billed 2,200,443 times to 1,492,523 Medicare beneficiaries by 1,895 providers in 2024.

Does 87088 pay differently in an office than a hospital?

Yes. The allowed amount averaged $7.92 in an office setting and $7.93 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 87088 most?

Clinical Laboratory, with 2,080,474 services from 398 clinicians. Next are Urology, Pathology, Nurse Practitioner.

CPT 87088

Bacterial urine culture

$7.92Medicare-allowed amount per service, averaged across 2,200,443 services

Providers submitted

$31.23

Asking price, not received

Medicare allowed

$7.92

The fee schedule figure

Medicare paid

$7.92

Balance is patient coinsurance

Providers submitted an average of $31.23 for this code and Medicare allowed $7.92 — 3.9× 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 $7.92 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $7.92
Hospital / facility: $7.93

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 2,200,309 services were billed in an office setting and 134 in a facility.

Services: 2,200,443
Beneficiaries: 1,492,523
Providers billing it: 1,895
Total allowed: $17,427,509

What Medicare pays for CPT 87088

Across 2,200,443 services billed by 1,895 providers to 1,492,523 beneficiaries, Medicare allowed an average of $7.92 per service. That is 1.5 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 87088

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	2,080,474	1,404,429	$7.92	398
Urology	40,133	26,981	$7.90	417
Pathology	39,798	29,646	$7.88	25
Nurse Practitioner	10,445	8,026	$7.89	228
Family Practice	10,202	7,982	$7.90	322
Internal Medicine	7,815	6,051	$7.91	225
Physician Assistant	7,021	5,724	$7.88	170
Obstetrics & Gynecology	1,633	1,212	$7.88	22
Emergency Medicine	1,307	1,267	$7.84	57
Nephrology	635	494	$7.87	15
Cardiology	317	211	$7.91	4
Hematology-Oncology	241	217	$7.93	2
Pediatric Medicine	176	103	$7.93	3
General Practice	109	102	$7.80	2
Infectious Disease	87	39	$7.86	2

87088 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	300,920	$7.92	$7.93	265
Florida	271,193	$7.93	$7.93	60
California	244,877	$7.91	$7.93	62
Texas	214,952	$7.92	$7.93	171
North Carolina	142,783	$7.93	$7.93	21
Arizona	96,857	$7.92	$7.93	43
Illinois	90,654	$7.93	$7.93	23
Massachusetts	90,159	$7.93	$7.93	6
New York	84,143	$7.93	$7.93	158
Georgia	83,220	$7.93	$7.93	7
Ohio	66,708	$7.92	$7.93	215
Kansas	64,624	$7.93	$7.93	5
Alabama	63,754	$7.92	$7.93	58
Pennsylvania	51,843	$7.93	$7.93	17
Washington	44,420	$7.93	$7.93	45
Maryland	33,939	$7.93	$7.93	5
Oklahoma	33,025	$7.92	$7.93	8
Virginia	28,938	$7.92	$7.93	79
Colorado	28,718	$7.92	$7.93	7
Nevada	20,748	$7.93	$7.93	3
South Carolina	19,724	$7.92	$7.93	7
Louisiana	15,759	$7.92	$7.93	18
Missouri	15,524	$7.93	$7.93	4
Tennessee	12,849	$7.91	$7.93	88
Wisconsin	10,783	$7.84	$7.93	17
Michigan	10,240	$7.91	$7.93	14
Oregon	9,267	$7.86	$7.93	32
Kentucky	8,838	$7.93	$7.93	53
Indiana	8,114	$7.91	$7.93	45
Puerto Rico	7,347	$7.89	$7.93	98
Hawaii	7,245	$7.91	$7.93	2
Utah	5,205	$7.90	$7.93	107
Minnesota	4,811	$7.90	$7.93	105
Delaware	1,526	$7.93	$7.93	1
U.S. Virgin Islands	1,233	$7.93	$7.93	5
Connecticut	1,103	$7.88	$7.93	5
South Dakota	1,005	$7.92	$7.93	8
Idaho	861	$7.92	$7.93	3
Mississippi	762	$7.93	$7.93	3
North Dakota	404	$7.92	$7.93	4
Wyoming	329	$7.93	$7.93	2
Nebraska	259	$7.90	$7.93	2
Arkansas	246	$7.67	$7.93	6
West Virginia	203	$7.93	$7.93	1
District of Columbia	150	$7.88	$7.93	2
New Mexico	100	$7.93	$7.93	2
Montana	65	$7.85	$7.93	2
Vermont	16	$7.93	$7.93	1

Related codes

87086Bacterial colony count$7.90
87077Bacterial culture for aerobic isolates$7.91
87070Bacterial culture$8.44
87075Bacterial culture$9.27
87045Stool culture$9.24
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

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.