RxDoctor Payments Data

CPT 87389

Detection test by immunoassay technique for hiv-1 antigen and hiv-1 and hiv-2 antibodies

$23.57Medicare-allowed amount per service, averaged across 187,818 services
Providers submitted
$125.50

Asking price, not received

Medicare allowed
$23.57

The fee schedule figure

Medicare paid
$23.57

Balance is patient coinsurance

Providers submitted an average of $125.50 for this code and Medicare allowed $23.575.3× 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 $23.57 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$23.57
Hospital / facility
$23.60

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 187,777 services were billed in an office setting and 41 in a facility.

Services
187,818

Medicare Part B, 2024

Beneficiaries
177,323
Providers billing it
348
Total allowed
$4,426,870

Services × allowed amount

What Medicare pays for CPT 87389

Across 187,818 services billed by 348 providers to 177,323 beneficiaries, Medicare allowed an average of $23.57 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 87389

SpecialtyServicesBeneficiariesAvg allowedProviders
Clinical Laboratory184,557174,159$23.57261
Pathology1,4751,410$23.5014
Family Practice628609$23.4213
Hematology-Oncology360358$23.4822
Internal Medicine354349$23.4714
Medical Oncology9291$23.606
Infectious Disease5856$23.602
Emergency Medicine4342$23.601
Obstetrics & Gynecology4240$23.603
Neuropsychiatry3636$23.601
Nephrology2626$23.602
Hospitalist2222$23.601
Physician Assistant2121$23.601
Neurology1818$23.601
Hematology1818$23.601

87389 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.

StateServicesAllowedStandardized pmtProviders
California33,441$23.58$23.6031
New Jersey29,769$23.57$23.6016
North Carolina19,291$23.58$23.6011
Texas15,487$23.56$23.6021
Florida14,275$23.58$23.6017
Massachusetts6,679$23.60$23.6016
Illinois6,555$23.59$23.6015
Arizona6,058$23.57$23.603
Ohio6,046$23.58$23.6012
Kansas6,045$23.59$23.604
Georgia5,498$23.60$23.605
Alabama4,783$23.54$23.607
Tennessee4,306$23.54$23.609
New York4,025$23.58$23.6049
Washington3,661$23.58$23.609
Maryland3,051$23.55$23.606
Oklahoma2,378$23.56$23.606
Pennsylvania2,275$23.56$23.6011
Nevada2,234$23.51$23.594
Michigan1,867$23.52$23.6012
Colorado1,368$23.49$23.603
Virginia1,055$23.49$23.604
Oregon945$23.40$23.604
Wisconsin895$22.98$23.605
Mississippi894$23.54$23.607
New Mexico588$23.56$23.601
Kentucky507$23.47$23.605
Hawaii459$23.60$23.601
Minnesota426$23.38$23.606
Rhode Island377$23.60$23.603
Maine331$22.93$23.601
Louisiana300$23.60$23.606
West Virginia291$23.60$23.602
Connecticut277$23.51$23.607
South Carolina257$23.36$23.605
Iowa220$23.49$23.603
Indiana176$23.33$23.604
U.S. Virgin Islands171$23.22$23.482
Puerto Rico146$22.75$23.604
Nebraska112$23.60$23.601
Utah108$23.60$23.603
South Dakota65$23.31$23.601
Vermont37$23.60$23.602
Montana28$23.60$23.601
Arkansas26$23.60$23.601
North Dakota24$23.60$23.601
Delaware11$23.60$23.601

Related codes

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.