How much does Medicare pay for CPT 87511?

Medicare allowed an average of $34.34 per service and paid $34.34 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $66.37, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87511?

Detection test for gardnerella vaginalis (bacteria), amplified probe technique. It was billed 91,453 times to 67,781 Medicare beneficiaries by 210 providers in 2024.

Which specialty bills 87511 most?

Clinical Laboratory, with 75,601 services from 113 clinicians. Next are Pathology, Urology, Physician Assistant.

CPT 87511

Detection test for gardnerella vaginalis (bacteria), amplified probe technique

$34.34Medicare-allowed amount per service, averaged across 91,453 services

Providers submitted

$66.37

Asking price, not received

Medicare allowed

$34.34

The fee schedule figure

Medicare paid

$34.34

Balance is patient coinsurance

Providers submitted an average of $66.37 for this code and Medicare allowed $34.34 — 1.9× 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 $34.34 (100%); the rest is the patient’s coinsurance and deductible.

Services: 91,453
Beneficiaries: 67,781
Providers billing it: 210
Total allowed: $3,140,496

What Medicare pays for CPT 87511

Across 91,453 services billed by 210 providers to 67,781 beneficiaries, Medicare allowed an average of $34.34 per service. That is 1.3 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 87511

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	75,601	55,474	$34.34	113
Pathology	10,874	8,877	$34.31	14
Urology	3,607	2,321	$34.35	39
Physician Assistant	376	295	$34.30	7
Obstetrics & Gynecology	361	294	$34.39	16
Nurse Practitioner	339	242	$34.39	8
Hematology-Oncology	137	136	$34.19	7
Hematology	48	46	$33.77	1
Family Practice	38	27	$34.39	1
Hospitalist	22	22	$34.39	1
General Practice	18	15	$34.39	1
Internal Medicine	17	17	$34.39	1
Medical Oncology	15	15	$34.39	1

87511 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
Florida	24,606	$34.33	$34.39	19
Texas	19,309	$34.35	$34.39	43
Arizona	10,741	$34.38	$34.39	3
New Jersey	10,610	$34.28	$34.39	9
Oklahoma	5,736	$34.36	$34.39	19
New York	4,198	$34.37	$34.39	20
Missouri	2,715	$34.37	$34.39	6
Pennsylvania	2,571	$34.39	$34.39	6
Michigan	2,238	$34.27	$34.39	5
Illinois	2,233	$34.19	$34.39	7
California	1,716	$34.39	$34.39	14
Tennessee	1,562	$34.30	$34.39	2
Colorado	616	$34.39	$34.39	10
Washington	514	$34.28	$34.39	2
Nebraska	459	$34.39	$34.39	10
Utah	313	$34.39	$34.39	1
Louisiana	270	$34.39	$34.39	3
Mississippi	111	$34.39	$34.39	3
Kansas	110	$34.39	$34.39	3
Arkansas	107	$34.39	$34.39	2
Massachusetts	99	$34.39	$34.39	4
North Carolina	94	$34.39	$34.39	1
Alabama	93	$32.36	$33.70	4
Maine	86	$34.39	$34.39	1
Minnesota	55	$34.39	$34.39	2
New Mexico	52	$33.86	$34.39	1
Indiana	51	$34.39	$34.39	1
Maryland	50	$34.39	$34.39	2
Oregon	42	$34.39	$34.39	1
Virginia	33	$34.39	$34.39	2
Ohio	18	$34.39	$34.39	1
Rhode Island	17	$34.39	$34.39	1
Connecticut	15	$34.39	$34.39	1
Nevada	13	$34.39	$34.39	1

Related codes

87500Detection test by nucleic acid for vancomycin resistance strep (vre)$34.35
87581Detection test by nucleic acid for mycoplasma pneumoniae (bacteria)$34.37
87591Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae$34.35
87502Detection test by nucleic acid for multiple types influenza virus$92.99
87529Detection test by nucleic acid for herpes simplex virus$34.33
87563Detection of mycoplasma genitalium by dna or rna probe$34.36
87541Detection test by nucleic acid for legionella pneumophila (water borne$34.38
87556Detection test by nucleic acid for mycobacteria tuberculosis (tb bacte$40.79
87536Detection test by nucleic acid for hiv-1 virus$83.30
87522Detection test by nucleic acid for hepatitis c virus$41.95
87532Detection test by nucleic acid for herpes virus-6$34.38
87517Detection test by nucleic acid for hepatitis b virus$41.93

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.