How much does Medicare pay for CPT 87899?

Medicare allowed an average of $15.70 per service and paid $15.70 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $66.72, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87899?

Detection test by immunoassay with direct visual observation for other organism. It was billed 10,873 times to 8,675 Medicare beneficiaries by 98 providers in 2024.

Which specialty bills 87899 most?

Clinical Laboratory, with 8,997 services from 61 clinicians. Next are Family Practice, Nurse Practitioner, Internal Medicine.

CPT 87899

Detection test by immunoassay with direct visual observation for other organism

$15.70Medicare-allowed amount per service, averaged across 10,873 services

Providers submitted

$66.72

Asking price, not received

Medicare allowed

$15.70

The fee schedule figure

Medicare paid

$15.70

Balance is patient coinsurance

Providers submitted an average of $66.72 for this code and Medicare allowed $15.70 — 4.2× 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 $15.70 (100%); the rest is the patient’s coinsurance and deductible.

Services: 10,873
Beneficiaries: 8,675
Providers billing it: 98
Total allowed: $170,706

What Medicare pays for CPT 87899

Across 10,873 services billed by 98 providers to 8,675 beneficiaries, Medicare allowed an average of $15.70 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 87899

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	8,997	7,214	$15.71	61
Family Practice	747	426	$15.52	6
Nurse Practitioner	336	327	$15.75	14
Internal Medicine	250	195	$15.69	6
Podiatry	223	219	$15.69	5
Pathology	191	171	$15.75	2
Hematology-Oncology	64	61	$15.75	1
Physician Assistant	33	31	$15.75	2
Emergency Medicine	32	31	$15.75	1

87899 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
California	3,146	$15.69	$15.74	21
Virginia	1,552	$15.74	$15.75	3
Texas	927	$15.62	$15.75	27
Hawaii	822	$15.73	$15.75	2
Arizona	818	$15.64	$15.75	6
North Carolina	602	$15.75	$15.75	1
Oklahoma	593	$15.73	$15.75	1
Massachusetts	562	$15.75	$15.75	2
Florida	410	$15.68	$15.75	4
Ohio	267	$15.75	$15.75	7
Minnesota	212	$15.71	$15.75	2
Pennsylvania	172	$15.75	$15.75	2
Oregon	102	$15.54	$15.75	1
Alabama	95	$15.75	$15.75	2
South Dakota	92	$15.63	$15.75	3
Illinois	80	$15.75	$15.75	1
New Jersey	73	$15.75	$15.75	2
Louisiana	69	$15.75	$15.75	1
Mississippi	61	$15.75	$15.75	1
Indiana	45	$15.75	$15.75	1
New York	36	$15.75	$15.75	2
Washington	35	$15.75	$15.75	1
Kentucky	33	$15.75	$15.75	2
Maryland	24	$15.75	$15.75	1
Iowa	23	$15.75	$15.75	1
Tennessee	22	$15.75	$15.75	1

Related codes

87804Detection test by immunoassay$16.08
87811Detection test by immunoassay$40.21
87801Detection test by nucleic acid for multiple organisms$68.67
87880Detection test by immunoassay$16.04
87807Detection test by immunoassay$12.74
87800Detection test by nucleic acid for multiple organisms$42.68
87806Detection test by immunoassay$32.06

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.