87640

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

Medicare pricing data for 1,942 providers across 44 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique (HCPCS code 87640) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $34.33, but hospitals typically charge $62.02 — a 1.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$6.87

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $34.33, your out-of-pocket cost would be approximately $6.87. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$34.33
Average Hospital Charge
$62.02
Markup Ratio
1.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$62.02
Medicare Allowed$34.33
Medicare Payment$34.33

Hospitals charge 1.8x more than what Medicare allows for this procedure. Medicare actually pays $34.33 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Michigan$34$49233,391+0.2%
Idaho$34$621158+0.2%
Nebraska$34$6420296+0.2%
Nevada$34$524100+0.2%
New Hampshire$34$90518+0.2%
North Carolina$34$4376,267+0.2%
North Dakota$34$150215+0.2%
Rhode Island$34$7022203+0.2%
Utah$34$107132,058+0.2%
West Virginia$34$105116+0.2%
Connecticut$34$50216+0.2%
Indiana$34$401013,887+0.1%
Massachusetts$34$96626,117+0.1%
Pennsylvania$34$493350,988+0.1%
California$34$5310669,620+0.1%
Maryland$34$768623,178+0.1%
Colorado$34$64877,403+0.1%
Texas$34$57412191,149+0.1%
Illinois$34$659923,371+0.1%
New Jersey$34$744917,301+0.1%
Oklahoma$34$545323,023+0.1%
New Mexico$34$6111647+0.0%
Florida$34$6411264,8540.0%
Kansas$34$12371,9990.0%
Kentucky$34$51111,0030.0%
Arizona$34$53161,8530.0%
New York$34$1095017,221-0.0%
Delaware$34$73222,765-0.1%
Georgia$34$5318682-0.1%
Mississippi$34$8610416,006-0.1%
Washington$34$75281,928-0.1%
Missouri$34$117123,243-0.2%
Ohio$34$69332,868-0.2%
Tennessee$34$74392,706-0.2%
Arkansas$34$695921,248-0.2%
Iowa$34$8013306-0.3%
Minnesota$34$6858638-0.3%
Virginia$34$57569,576-0.3%
Oregon$34$8322411-0.7%
Louisiana$34$577520,324-0.9%
District of Columbia$34$373118-1.2%
Wisconsin$34$151423,271-1.2%
Alabama$34$40292,289-1.9%
South Carolina$29$60944-14.8%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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