How much does Medicare pay for CPT 87591?

Medicare allowed an average of $34.35 per service and paid $34.35 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $84.12, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87591?

Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique. It was billed 255,271 times to 204,624 Medicare beneficiaries by 580 providers in 2024.

Does 87591 pay differently in an office than a hospital?

Yes. The allowed amount averaged $34.35 in an office setting and $34.39 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 87591 most?

Clinical Laboratory, with 240,037 services from 399 clinicians. Next are Urology, Pathology, Obstetrics & Gynecology.

CPT 87591

Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique

$34.35Medicare-allowed amount per service, averaged across 255,271 services

Providers submitted

$84.12

Asking price, not received

Medicare allowed

$34.35

The fee schedule figure

Medicare paid

$34.35

Balance is patient coinsurance

Providers submitted an average of $84.12 for this code and Medicare allowed $34.35 — 2.4× 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 $34.35 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $34.35
Hospital / facility: $34.39

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 255,233 services were billed in an office setting and 38 in a facility.

Services: 255,271
Beneficiaries: 204,624
Providers billing it: 580
Total allowed: $8,768,559

What Medicare pays for CPT 87591

Across 255,271 services billed by 580 providers to 204,624 beneficiaries, Medicare allowed an average of $34.35 per service. That is 1.2 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 87591

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	240,037	192,914	$34.35	399
Urology	5,588	3,768	$34.32	37
Pathology	4,284	3,951	$34.24	47
Obstetrics & Gynecology	2,105	1,875	$34.28	46
Physician Assistant	907	765	$34.30	13
Nurse Practitioner	609	438	$34.14	9
Family Practice	589	339	$34.39	10
Internal Medicine	580	274	$34.34	8
Infectious Disease	433	185	$34.39	4
Hematology-Oncology	57	55	$34.39	4
Gastroenterology	39	23	$34.39	1
General Practice	23	18	$34.39	1
Hematology	20	19	$32.91	1

87591 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	58,135	$34.37	$34.39	77
California	40,929	$34.37	$34.39	89
New Jersey	30,328	$34.34	$34.39	20
Pennsylvania	22,928	$34.39	$34.39	20
Florida	21,524	$34.30	$34.39	38
Arizona	11,236	$34.36	$34.39	8
Illinois	9,227	$34.38	$34.39	25
Oklahoma	8,293	$34.32	$34.39	21
New York	7,712	$34.35	$34.39	50
North Carolina	5,832	$34.35	$34.39	6
Massachusetts	5,500	$34.38	$34.39	12
Colorado	3,369	$34.39	$34.39	13
Utah	3,293	$34.32	$34.39	3
Michigan	2,659	$34.27	$34.38	15
Missouri	2,475	$34.36	$34.38	7
Maryland	2,218	$34.36	$34.39	10
Alabama	2,128	$34.23	$34.39	5
Kansas	1,490	$34.35	$34.39	8
Tennessee	1,325	$34.39	$34.39	16
West Virginia	1,283	$34.37	$34.39	2
Nevada	1,179	$34.02	$34.39	7
Washington	1,166	$34.16	$34.39	11
Ohio	1,090	$34.39	$34.39	6
Louisiana	1,082	$34.39	$34.39	13
Georgia	1,022	$34.39	$34.39	3
Oregon	936	$34.17	$34.39	7
Arkansas	855	$34.39	$34.39	7
Wisconsin	841	$33.26	$34.39	4
Mississippi	768	$34.32	$34.39	10
Nebraska	699	$34.27	$34.39	12
Virginia	501	$34.10	$34.39	7
Puerto Rico	476	$34.21	$34.39	6
Minnesota	452	$34.08	$34.39	5
Hawaii	424	$34.35	$34.39	2
Indiana	381	$34.31	$34.39	5
South Carolina	285	$34.24	$34.39	4
New Mexico	248	$34.13	$34.39	3
Rhode Island	169	$34.39	$34.39	2
Kentucky	167	$34.05	$34.39	4
Iowa	150	$34.39	$34.39	3
New Hampshire	139	$34.14	$34.39	1
Connecticut	107	$33.56	$34.39	3
Maine	64	$34.39	$34.39	1
Delaware	61	$34.39	$34.39	4
South Dakota	41	$34.39	$34.39	1
Montana	24	$34.39	$34.39	1
U.S. Virgin Islands	23	$33.92	$34.39	1
Idaho	22	$32.83	$34.39	1
North Dakota	15	$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
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
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.