How much does Medicare pay for CPT 87400?

Medicare allowed an average of $13.75 per service and paid $13.75 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $47.65, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87400?

Detection test by immunoassay technique for influenza virus. It was billed 56,938 times to 29,377 Medicare beneficiaries by 892 providers in 2024.

Which specialty bills 87400 most?

Nurse Practitioner, with 21,693 services from 346 clinicians. Next are Physician Assistant, Family Practice, Internal Medicine.

CPT 87400

Detection test by immunoassay technique for influenza virus

$13.75Medicare-allowed amount per service, averaged across 56,938 services

Providers submitted

$47.65

Asking price, not received

Medicare allowed

$13.75

The fee schedule figure

Medicare paid

$13.75

Balance is patient coinsurance

Providers submitted an average of $47.65 for this code and Medicare allowed $13.75 — 3.5× 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 $13.75 (100%); the rest is the patient’s coinsurance and deductible.

Services: 56,938
Beneficiaries: 29,377
Providers billing it: 892
Total allowed: $782,898

What Medicare pays for CPT 87400

Across 56,938 services billed by 892 providers to 29,377 beneficiaries, Medicare allowed an average of $13.75 per service. That is 1.9 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 87400

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	21,693	10,920	$13.75	346
Physician Assistant	15,790	7,795	$13.82	197
Family Practice	11,575	6,226	$13.70	218
Internal Medicine	3,344	1,882	$13.78	71
Emergency Medicine	2,075	1,051	$13.74	24
Clinical Laboratory	1,017	677	$13.68	9
General Practice	531	315	$13.19	9
General Surgery	376	184	$13.85	4
Hospitalist	161	87	$13.85	2
Pediatric Medicine	61	41	$13.85	2
Urology	54	25	$13.61	1
Rheumatology	47	40	$13.27	1
Colorectal Surgery (Proctology)	34	17	$13.85	1
Osteopathic Manipulative Medicine	34	17	$13.12	1
Certified Clinical Nurse Specialist	31	16	$13.85	1

87400 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
Maryland	13,635	$13.79	$13.85	94
Mississippi	6,816	$13.71	$13.85	61
Texas	6,161	$13.75	$13.84	107
Massachusetts	4,399	$13.82	$13.85	85
Arkansas	2,654	$13.79	$13.85	47
Florida	2,626	$13.85	$13.85	64
Virginia	2,269	$13.74	$13.85	20
Tennessee	1,720	$13.59	$13.85	38
Kentucky	1,632	$13.53	$13.85	43
Oklahoma	1,542	$13.69	$13.85	45
Alabama	1,196	$13.73	$13.85	17
Indiana	1,051	$13.71	$13.85	32
California	1,040	$13.75	$13.85	40
Louisiana	996	$13.63	$13.85	6
New Hampshire	902	$13.82	$13.85	20
North Carolina	845	$13.81	$13.85	21
District of Columbia	721	$13.77	$13.85	7
Illinois	592	$13.81	$13.85	10
Delaware	574	$13.66	$13.85	4
Georgia	434	$13.78	$13.85	11
Rhode Island	389	$13.85	$13.85	4
Pennsylvania	385	$13.85	$13.85	5
Idaho	365	$13.80	$13.85	6
Ohio	357	$13.24	$13.85	9
New Jersey	348	$13.85	$13.85	11
South Carolina	322	$13.76	$13.85	8
West Virginia	314	$13.77	$13.85	6
Colorado	288	$13.85	$13.85	5
Vermont	282	$13.85	$13.85	6
New York	233	$13.85	$13.85	6
Missouri	221	$13.85	$13.85	7
Kansas	210	$13.74	$13.85	5
Wyoming	182	$13.85	$13.85	4
Nevada	163	$13.68	$13.85	6
Iowa	129	$13.85	$13.85	5
Washington	127	$13.85	$13.85	3
Michigan	124	$13.85	$13.85	3
Connecticut	110	$13.85	$13.85	3
Utah	102	$13.59	$13.85	2
Montana	72	$13.85	$13.85	2
New Mexico	59	$13.54	$13.85	2
Puerto Rico	54	$13.85	$13.85	2
Alaska	54	$13.85	$13.85	2
Arizona	52	$13.85	$13.85	2
Hawaii	51	$13.85	$13.85	1
North Dakota	42	$13.85	$13.85	1
AE	34	$13.85	$13.85	1
U.S. Virgin Islands	28	$13.85	$13.85	1
Maine	22	$13.85	$13.85	1
Nebraska	14	$13.85	$13.85	1

Related codes

87481Detection test for candida species (yeast)$34.05
87426Detection test by immunoassay technique for severe acute respiratory s$34.33
87428Detection test by immunoassay technique for severe acute respiratory s$67.08
87486Detection test by nucleic acid for chlamydia pneumoniae$34.36
87491Detection test by nucleic acid for chlamydia trachomatis$34.35
87449Detection test by immunoassay technique for other organism$11.73
87498Detection test by nucleic acid for enterovirus (intestinal virus)$34.38
87497Detection test by nucleic acid for cytomegalovirus$41.82
87493Detection test by nucleic acid for clostridium difficile$36.38
87427Detection test by immunoassay technique for shiga-like toxin (bacteria$11.69
87496Detection test by nucleic acid for cytomegalovirus (cmv)$34.38
87480Detection test for candida species (yeast)$19.59

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.