How much does Medicare pay for CPT 87529?

Medicare allowed an average of $34.33 per service and paid $34.33 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $86.07, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87529?

Detection test by nucleic acid for herpes simplex virus, amplified probe technique. It was billed 219,064 times to 96,088 Medicare beneficiaries by 326 providers in 2024.

Which specialty bills 87529 most?

Clinical Laboratory, with 210,604 services from 226 clinicians. Next are Urology, Pathology, Obstetrics & Gynecology.

CPT 87529

Detection test by nucleic acid for herpes simplex virus, amplified probe technique

$34.33Medicare-allowed amount per service, averaged across 219,064 services

Providers submitted

$86.07

Asking price, not received

Medicare allowed

$34.33

The fee schedule figure

Medicare paid

$34.33

Balance is patient coinsurance

Providers submitted an average of $86.07 for this code and Medicare allowed $34.33 — 2.5× 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 $34.33 (100%); the rest is the patient’s coinsurance and deductible.

Services: 219,064
Beneficiaries: 96,088
Providers billing it: 326
Total allowed: $7,520,467

What Medicare pays for CPT 87529

Across 219,064 services billed by 326 providers to 96,088 beneficiaries, Medicare allowed an average of $34.33 per service. That is 2.3 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 87529

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	210,604	91,533	$34.33	226
Urology	4,034	2,316	$34.39	47
Pathology	3,157	1,639	$34.27	27
Obstetrics & Gynecology	416	162	$34.32	7
Hematology-Oncology	316	166	$34.17	9
Nurse Practitioner	160	64	$34.39	1
Hematology	96	46	$33.72	1
Physician Assistant	92	50	$33.72	3
Internal Medicine	84	44	$34.39	2
Hospitalist	44	22	$34.39	1
Podiatry	31	31	$34.39	1
Medical Oncology	30	15	$34.39	1

87529 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
Texas	97,895	$34.38	$34.39	79
Pennsylvania	41,496	$34.39	$34.39	12
California	18,545	$34.38	$34.39	40
Florida	15,955	$33.90	$34.39	30
Oklahoma	9,283	$34.38	$34.39	11
New Jersey	6,859	$34.32	$34.39	22
Arizona	5,571	$34.01	$34.39	4
North Carolina	2,931	$34.39	$34.39	3
Illinois	2,821	$34.38	$34.39	10
New York	2,642	$34.31	$34.39	16
Michigan	2,352	$34.31	$34.39	6
Kansas	1,451	$34.33	$34.39	5
Virginia	1,009	$34.39	$34.39	5
Mississippi	983	$34.39	$34.39	4
Tennessee	933	$34.30	$34.39	4
Massachusetts	918	$34.39	$34.39	5
Louisiana	825	$34.39	$34.39	3
Ohio	704	$34.39	$34.39	7
Maryland	695	$34.39	$34.39	4
Missouri	686	$34.14	$34.30	1
Indiana	562	$34.39	$34.39	4
Iowa	554	$34.39	$34.39	8
Wisconsin	551	$33.92	$34.39	2
Minnesota	456	$34.31	$34.39	4
Georgia	264	$34.39	$34.39	2
Colorado	263	$34.39	$34.39	5
Oregon	248	$34.18	$34.39	3
Hawaii	228	$33.93	$34.39	2
Washington	219	$34.39	$34.39	4
Alabama	214	$34.16	$34.39	4
Nevada	193	$34.03	$34.39	3
Arkansas	173	$34.39	$34.39	2
New Mexico	149	$34.19	$34.39	2
South Dakota	84	$34.39	$34.39	1
New Hampshire	62	$34.39	$34.39	1
Utah	52	$34.39	$34.39	1
Kentucky	50	$34.39	$34.39	1
Connecticut	44	$34.39	$34.39	1
North Dakota	38	$34.39	$34.39	1
Nebraska	32	$34.39	$34.39	1
Rhode Island	30	$34.39	$34.39	1
Maine	24	$34.39	$34.39	1
West Virginia	20	$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
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
87511Detection test for gardnerella vaginalis (bacteria)$34.34
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.