How much does Medicare pay for CPT 87106?

Medicare allowed an average of $10.10 per service and paid $10.10 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $62.39, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87106?

Fungal culture, yeast. It was billed 20,337 times to 17,166 Medicare beneficiaries by 127 providers in 2024.

Does 87106 pay differently in an office than a hospital?

Yes. The allowed amount averaged $10.10 in an office setting and $10.11 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 87106 most?

Clinical Laboratory, with 19,662 services from 114 clinicians. Next are Pathology, Podiatry, Dermatology.

CPT 87106

Fungal culture, yeast

$10.10Medicare-allowed amount per service, averaged across 20,337 services

Providers submitted

$62.39

Asking price, not received

Medicare allowed

$10.10

The fee schedule figure

Medicare paid

$10.10

Balance is patient coinsurance

Providers submitted an average of $62.39 for this code and Medicare allowed $10.10 — 6.2× 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 $10.10 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $10.10
Hospital / facility: $10.11

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 20,318 services were billed in an office setting and 19 in a facility.

Services: 20,337
Beneficiaries: 17,166
Providers billing it: 127
Total allowed: $205,404

What Medicare pays for CPT 87106

Across 20,337 services billed by 127 providers to 17,166 beneficiaries, Medicare allowed an average of $10.10 per service. That is 1.2 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 87106

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	19,662	16,558	$10.10	114
Pathology	388	345	$10.11	6
Podiatry	164	160	$10.11	2
Dermatology	57	50	$10.11	2
Obstetrics & Gynecology	47	36	$10.11	2
Hematology-Oncology	19	17	$10.11	1

87106 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	2,876	$10.10	$10.11	7
California	2,610	$10.09	$10.11	22
Florida	2,526	$10.10	$10.11	11
North Carolina	1,813	$10.10	$10.11	2
Texas	1,560	$10.11	$10.11	7
Massachusetts	1,075	$10.11	$10.11	5
Wisconsin	781	$10.01	$10.11	3
Georgia	717	$10.11	$10.11	2
Illinois	688	$10.11	$10.11	1
Alabama	501	$10.06	$10.11	3
Kansas	492	$10.04	$10.11	2
Pennsylvania	410	$10.11	$10.11	5
Tennessee	400	$10.11	$10.11	4
Minnesota	346	$10.11	$10.11	4
Ohio	331	$10.10	$10.11	5
Arkansas	307	$10.11	$10.11	1
Nevada	301	$10.05	$10.11	1
New York	249	$10.11	$10.11	4
Maryland	235	$10.07	$10.11	2
Virginia	209	$10.11	$10.11	3
Hawaii	201	$10.11	$10.11	2
Washington	177	$10.11	$10.11	4
Missouri	177	$10.11	$10.11	1
Arizona	173	$10.11	$10.11	2
Oklahoma	170	$10.11	$10.11	3
Utah	156	$10.11	$10.11	1
Mississippi	137	$10.11	$10.11	2
Colorado	128	$10.11	$10.11	2
Indiana	126	$10.11	$10.11	1
South Dakota	114	$10.11	$10.11	2
Oregon	109	$10.11	$10.11	2
Iowa	98	$10.11	$10.11	4
Nebraska	41	$10.11	$10.11	1
Kentucky	29	$9.79	$10.11	1
Maine	21	$10.11	$10.11	1
North Dakota	18	$10.11	$10.11	1
Connecticut	13	$10.11	$10.11	1
Louisiana	11	$10.11	$10.11	1
Delaware	11	$10.11	$10.11	1

Related codes

87186Evaluation of antimicrobial drug (antibiotic$8.47
87150Identification of organisms by genetic analysis$34.30
87177Smear for parasites$8.69
87184Evaluation of antimicrobial drug (antibiotic$7.32
87147Identification of organisms by immunologic analysis$5.08
87101Fungal culture (mold or yeast) of skin$7.56
87102Fungal culture (mold or yeast)$8.23
87116Culture for acid-fast bacilli$10.56
87181Evaluation of antimicrobial drug (antibiotic$4.63
87107Culture for identification of yeast$10.11
87185Detection of antimicrobial drug (antibiotic$4.65
87118Identification of mycobacteria (tb or tb like organism)$14.31

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.