CPT 87338

Across 58,715 services billed by 178 providers to 56,365 beneficiaries, Medicare allowed an average of $14.03 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.

• 87340Detection test by immunoassay technique for hepatitis b surface antige$10.10
• 87389Detection test by immunoassay technique for hiv-1 antigen and hiv-1 an$23.57
• 87324Detection test by immunoassay technique for clostridium difficile toxi$11.73
• 87329Detection test by immunoassay technique for giardia (intestinal parasi$11.73
• 87328Detection test by immunoassay technique for cryptosporidium (parasite)$13.52
• 87350Detection test by immunoassay technique for hepatitis be surface antig$11.29
• 87385Detection test by immunoassay technique for histoplasma capsulatum (pa$12.96
• 87305Detection test by immunoassay technique for aspergillus (fungus)$11.72
• 87341Detection test by immunoassay technique for hepatitis b surface antige$10.06

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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