How much does Medicare pay for CPT 87641?

Medicare allowed an average of $34.36 per service and paid $34.36 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $65.99, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87641?

Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique. It was billed 484,183 times to 342,471 Medicare beneficiaries by 767 providers in 2024.

Does 87641 pay differently in an office than a hospital?

Yes. The allowed amount averaged $34.36 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 87641 most?

Clinical Laboratory, with 429,407 services from 359 clinicians. Next are Urology, Pathology, Nurse Practitioner.

CPT 87641

Detection test by nucleic acid for staphylococcus aureus, methicillin resistant (mrsa bacteria), amplified probe technique

$34.36Medicare-allowed amount per service, averaged across 484,183 services

Providers submitted

$65.99

Asking price, not received

Medicare allowed

$34.36

The fee schedule figure

Medicare paid

$34.36

Balance is patient coinsurance

Providers submitted an average of $65.99 for this code and Medicare allowed $34.36 — 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 $34.36 (100%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $34.36
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. 484,148 services were billed in an office setting and 35 in a facility.

Services: 484,183
Beneficiaries: 342,471
Providers billing it: 767
Total allowed: $16,636,528

What Medicare pays for CPT 87641

Across 484,183 services billed by 767 providers to 342,471 beneficiaries, Medicare allowed an average of $34.36 per service. That is 1.4 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 87641

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	429,407	304,594	$34.36	359
Urology	31,716	19,613	$34.28	201
Pathology	6,600	5,372	$34.35	20
Nurse Practitioner	4,554	3,608	$34.29	56
Podiatry	3,886	3,168	$34.32	49
Physician Assistant	3,252	2,407	$34.33	35
Internal Medicine	1,989	1,381	$34.37	9
Family Practice	960	781	$34.32	10
Obstetrics & Gynecology	438	362	$34.32	6
Undersea and Hyperbaric Medicine	419	319	$34.10	1
Hematology-Oncology	400	344	$34.25	2
Neurosurgery	205	195	$33.81	5
General Surgery	122	112	$34.39	3
Emergency Medicine	82	73	$33.97	3
Orthopedic Surgery	78	76	$34.39	4

87641 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	153,091	$34.37	$34.39	178
Pennsylvania	54,581	$34.39	$34.39	26
Florida	47,570	$34.39	$34.39	72
California	43,974	$34.22	$34.39	57
Arizona	23,071	$34.37	$34.39	8
New Jersey	20,936	$34.38	$34.39	30
Arkansas	20,645	$34.33	$34.39	29
Maryland	19,457	$34.34	$34.39	54
Louisiana	18,923	$34.38	$34.39	18
Colorado	16,220	$34.38	$34.39	44
Mississippi	12,586	$34.35	$34.39	43
Indiana	10,440	$34.38	$34.39	4
Oklahoma	9,308	$34.33	$34.39	24
Virginia	7,896	$34.37	$34.39	21
Missouri	5,966	$34.35	$34.39	24
Kansas	3,494	$34.37	$34.39	22
Utah	2,943	$34.39	$34.39	5
Alabama	1,666	$34.24	$34.39	9
Oregon	1,515	$34.34	$34.39	4
North Carolina	1,484	$34.38	$34.39	7
Ohio	1,112	$34.20	$34.39	6
Michigan	1,041	$34.35	$34.39	9
Washington	1,018	$34.31	$34.36	4
Illinois	786	$34.39	$34.39	5
Nebraska	684	$34.27	$34.39	12
Georgia	675	$34.39	$34.39	3
Wyoming	620	$34.21	$34.39	8
New Mexico	501	$34.20	$34.39	8
Puerto Rico	464	$34.39	$34.39	2
Tennessee	246	$33.69	$34.39	7
Iowa	204	$34.39	$34.39	4
Delaware	176	$34.39	$34.39	3
North Dakota	168	$34.28	$34.39	2
Idaho	155	$34.17	$34.39	4
Massachusetts	124	$34.39	$34.39	1
District of Columbia	121	$34.39	$34.39	2
South Dakota	98	$34.39	$34.39	1
New York	48	$34.39	$34.39	1
Maine	46	$34.39	$34.39	1
South Carolina	35	$34.39	$34.39	1
Nevada	32	$34.39	$34.39	1
Alaska	23	$34.39	$34.39	1
Kentucky	21	$34.39	$34.39	1
Montana	19	$34.39	$34.39	1

Related codes

87640Detection test by nucleic acid for staphylococcus aureus (bacteria)$34.35
87653Detection test by nucleic acid for strep (streptococcus$34.36
87635Amplifed dna or rna probe detection of severe acute respiratory syndro$50.11
87651Detection test by nucleic acid for strep (streptococcus$34.33
87637Detection test by multiplex amplified probe technique for severe acute$139.09
87631Detection test by nucleic acid for multiple types of respiratory virus$139.46
87624Detection test by nucleic acid for human papillomavirus (hpv)$34.30
87636Detection test by multiplex amplified probe technique for severe acute$138.39
87661Detection test by nucleic acid for trichomonas vaginalis (genital para$34.30
87634Detection test by nucleic acid for respiratory syncytial virus$68.72
87652Detection test by nucleic acid for strep (streptococcus$40.89
87625Detection test by nucleic acid for human papillomavirus (hpv)$39.71

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.