How much does Medicare pay for CPT 87651?

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 $61.37, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87651?

Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique. It was billed 661,908 times to 510,658 Medicare beneficiaries by 3,908 providers in 2024.

Does 87651 pay differently in an office than a hospital?

Yes. The allowed amount averaged $34.33 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 87651 most?

Clinical Laboratory, with 515,848 services from 392 clinicians. Next are Nurse Practitioner, Urology, Pathology.

CPT 87651

Detection test by nucleic acid for strep (streptococcus, group a), amplified probe technique

$34.33Medicare-allowed amount per service, averaged across 661,908 services

Providers submitted

$61.37

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 $61.37 for this code and Medicare allowed $34.33 — 1.8× 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.

Office pays differently to hospital

Office / non-facility: $34.33
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. 661,860 services were billed in an office setting and 48 in a facility.

Services: 661,908
Beneficiaries: 510,658
Providers billing it: 3,908
Total allowed: $22,723,302

What Medicare pays for CPT 87651

Across 661,908 services billed by 3,908 providers to 510,658 beneficiaries, Medicare allowed an average of $34.33 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 87651

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	515,848	387,785	$34.37	392
Nurse Practitioner	34,215	32,746	$34.05	1,463
Urology	28,395	16,813	$34.30	181
Pathology	26,945	21,428	$34.30	38
Physician Assistant	22,355	21,163	$34.11	860
Family Practice	16,477	15,665	$33.98	559
Internal Medicine	6,654	5,619	$34.15	169
Emergency Medicine	5,160	5,042	$34.10	164
Podiatry	4,270	2,927	$34.38	37
General Practice	410	382	$34.10	13
Obstetrics & Gynecology	191	165	$34.39	6
Hematology-Oncology	184	177	$34.09	1
Nephrology	143	136	$34.20	4
Pulmonary Disease	110	98	$34.39	3
Cardiac Surgery	104	85	$34.39	1

87651 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	263,392	$34.36	$34.39	337
California	72,569	$34.38	$34.39	186
Florida	42,133	$34.37	$34.39	141
Pennsylvania	37,812	$34.38	$34.39	115
Arizona	31,145	$34.38	$34.39	26
Arkansas	20,887	$34.30	$34.39	59
Illinois	19,718	$34.27	$34.39	256
New York	18,683	$34.28	$34.39	201
Maryland	17,238	$34.27	$34.39	196
Colorado	15,237	$34.34	$34.39	129
Mississippi	15,016	$34.27	$34.39	165
Oklahoma	15,004	$34.32	$34.39	57
New Jersey	11,772	$34.30	$34.39	101
Georgia	9,489	$34.31	$34.39	29
Louisiana	9,372	$34.23	$34.39	123
Missouri	7,179	$34.22	$34.39	111
Massachusetts	7,020	$34.26	$34.39	216
Indiana	5,657	$34.21	$34.39	98
Tennessee	5,051	$34.05	$34.39	142
North Carolina	4,943	$34.00	$34.39	218
Utah	3,163	$34.38	$34.39	12
Minnesota	2,652	$33.99	$34.39	88
Virginia	2,529	$34.19	$34.39	66
Connecticut	2,444	$34.33	$34.39	75
Ohio	2,264	$34.29	$34.39	58
Iowa	2,153	$34.02	$34.39	59
Washington	1,820	$33.63	$34.39	86
Wisconsin	1,686	$33.80	$34.39	31
Kentucky	1,665	$33.79	$34.39	67
South Carolina	1,272	$34.15	$34.39	55
New Mexico	1,089	$34.18	$34.39	28
Kansas	1,067	$34.17	$34.39	48
Nebraska	997	$34.28	$34.39	31
Nevada	891	$33.73	$34.39	36
Michigan	876	$34.20	$34.39	23
Alabama	813	$33.61	$34.39	22
New Hampshire	811	$34.19	$34.39	25
South Dakota	625	$34.31	$34.39	26
West Virginia	583	$34.10	$34.39	20
Hawaii	475	$34.07	$34.39	16
Oregon	469	$34.00	$34.39	32
District of Columbia	468	$33.73	$34.39	20
Idaho	291	$33.82	$34.39	18
Montana	281	$34.39	$34.39	17
Alaska	275	$34.10	$34.39	12
Delaware	252	$34.25	$34.39	9
Rhode Island	228	$33.81	$34.39	9
North Dakota	164	$34.17	$34.39	2
Wyoming	147	$34.16	$34.39	6
Maine	118	$34.21	$34.39	4
AE	23	$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
87641Detection test by nucleic acid for staphylococcus aureus$34.36
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.