How much does Medicare pay for CPT 87207?

Medicare allowed an average of $7.96 per service and paid $7.30 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $73.51, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87207?

Special stain for inclusion bodies or parasites. It was billed 6,496 times to 5,831 Medicare beneficiaries by 62 providers in 2024.

Does 87207 pay differently in an office than a hospital?

Yes. The allowed amount averaged $5.87 in an office setting and $17.57 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 87207 most?

Clinical Laboratory, with 3,683 services from 39 clinicians. Next are Pathology, Dermatology.

CPT 87207

Special stain for inclusion bodies or parasites

$7.96Medicare-allowed amount per service, averaged across 6,496 services

Providers submitted

$73.51

Asking price, not received

Medicare allowed

$7.96

The fee schedule figure

Medicare paid

$7.30

Balance is patient coinsurance

Providers submitted an average of $73.51 for this code and Medicare allowed $7.96 — 9.2× 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 $7.30 (92%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $5.87
Hospital / facility: $17.57

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 5,337 services were billed in an office setting and 1,159 in a facility.

Services: 6,496
Beneficiaries: 5,831
Providers billing it: 62
Total allowed: $51,708

What Medicare pays for CPT 87207

Across 6,496 services billed by 62 providers to 5,831 beneficiaries, Medicare allowed an average of $7.96 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 87207

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	3,683	3,348	$5.87	39
Pathology	2,671	2,389	$10.95	22
Dermatology	142	94	$5.86	1

87207 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	2,680	$6.40	$6.22	6
Massachusetts	801	$11.08	$8.94	5
Texas	569	$12.14	$10.19	7
Florida	370	$5.87	$5.87	4
Pennsylvania	324	$15.76	$12.40	11
California	322	$5.87	$5.87	5
Tennessee	291	$5.87	$5.87	1
North Carolina	214	$5.87	$5.87	1
Georgia	178	$5.87	$5.87	1
New York	162	$8.84	$7.92	4
Mississippi	142	$5.86	$5.87	1
Maryland	78	$5.87	$5.87	1
Arizona	77	$5.87	$5.87	2
Missouri	49	$5.87	$5.87	1
Virginia	48	$11.86	$10.27	3
Illinois	39	$5.87	$5.87	1
Washington	36	$5.87	$5.87	2
Rhode Island	33	$5.87	$5.87	1
New Hampshire	22	$17.24	$12.92	1
Minnesota	18	$5.87	$5.87	1
Kansas	18	$5.87	$5.87	1
Connecticut	14	$17.13	$13.54	1
Oklahoma	11	$5.87	$5.87	1

Related codes

87205Special gram or giemsa stain for microorganism$4.17
87209Special stain for parasites$17.57
87206Special fluorescent and/or acid fast stain for microorganism$5.27
87210Smear for infectious agents$5.67
87220Tissue fungi or parasites$4.17
87255Virus isolation$33.06
87230Microbial toxin or antitoxin assay$19.34
87254Virus isolation$18.86
87275Detection test by immunofluorescent technique for influenza b virus$11.88
87276Detection test by immunofluorescent technique for influenza a virus$15.50
87252Tissue culture inoculation for virus isolation$25.53

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.