How much does Medicare pay for CPT 87900?

Medicare allowed an average of $127.42 per service and paid $127.42 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $229.98, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 87900?

Infectious agent drug susceptibility analysis. It was billed 22,274 times to 15,562 Medicare beneficiaries by 69 providers in 2024.

Which specialty bills 87900 most?

Clinical Laboratory, with 18,492 services from 38 clinicians. Next are Urology, Physician Assistant, Pathology.

CPT 87900

Infectious agent drug susceptibility analysis

$127.42Medicare-allowed amount per service, averaged across 22,274 services

Providers submitted

$229.98

Asking price, not received

Medicare allowed

$127.42

The fee schedule figure

Medicare paid

$127.42

Balance is patient coinsurance

Providers submitted an average of $229.98 for this code and Medicare allowed $127.42 — 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 $127.42 (100%); the rest is the patient’s coinsurance and deductible.

Services: 22,274
Beneficiaries: 15,562
Providers billing it: 69
Total allowed: $2,838,153

What Medicare pays for CPT 87900

Across 22,274 services billed by 69 providers to 15,562 beneficiaries, Medicare allowed an average of $127.42 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 87900

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Laboratory	18,492	12,566	$127.62	38
Urology	2,124	1,612	$126.50	14
Physician Assistant	1,062	873	$126.67	7
Pathology	245	243	$125.90	1
Nurse Practitioner	213	138	$124.86	2
Internal Medicine	138	130	$126.00	7

87900 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
Maryland	9,931	$127.74	$127.74	3
Texas	5,580	$127.50	$127.74	5
Oklahoma	1,853	$125.68	$127.74	9
Tennessee	1,405	$127.74	$127.74	10
California	883	$127.19	$127.74	6
North Carolina	490	$127.74	$127.74	1
New Jersey	414	$127.34	$127.74	4
Florida	338	$127.74	$127.74	3
Illinois	289	$126.18	$127.74	2
Alabama	266	$124.76	$127.74	10
West Virginia	196	$127.23	$127.74	1
Arizona	110	$127.74	$127.74	1
Mississippi	102	$127.74	$127.74	2
Georgia	95	$127.74	$127.74	1
Ohio	81	$127.74	$127.74	2
New York	75	$127.74	$127.74	2
Massachusetts	71	$127.74	$127.74	2
Kansas	35	$127.74	$127.74	1
Nevada	18	$127.74	$127.74	1
Pennsylvania	16	$127.74	$127.74	1
Washington	14	$125.56	$127.74	1
Louisiana	12	$127.74	$127.74	1

Related codes

87999Unlisted microbiology procedure$247.56
87902Analysis test by nucleic acid for hepatitis c virus$251.53
87901Analysis test by nucleic acid for hiv-1 virus$251.84
87906Analysis test by nucleic acid for hiv-1 virus$125.96

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.