CPT 87040: Blood Bacterial Culture with Isolation and Presumptive ID
Commercial payers pay $37 on average nationally for this procedure.
CPT code 87040 describes a bacterial culture of blood in which the laboratory analyst performs incubation on selected aerobic media and isolates and presumptively identifies any bacterial growth; the code also includes work for anaerobic culture when performed, and represents a microbiology laboratory culture service typically provided as a clinical laboratory diagnostic from hospital laboratories, outpatient laboratory facilities, or other certified clinical lab sites.
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National Reimbursement Benchmarks
For CPT 87040, BUCA’s average commercial rate sits at $37.2 and provides a useful midpoint for national commercial pricing. Blue Cross Blue Shield displays the highest central tendency with a median of $54.4 and a mean of $56.7, while Aetna and Cigna cluster much lower around medians of $8.5 and $9.3 respectively. UnitedHealth Group also trends low with a median of $6.2. These differences underscore a bifurcated market where BUCA’s average falls between the lower-tier payers (Aetna, Cigna, UnitedHealth Group) and Blue Cross Blue Shield’s higher reimbursements.
Dispersion measured by the interquartile range (P75–P25) highlights variability: Blue Cross Blue Shield is relatively wide with a range of $28.8 (P75 $69.8 minus P25 $42.1), indicating broader negotiated outcomes, while UnitedHealth Group is the tightest at $5.4 (P75 $10.3 minus P25 $4.6). Aetna’s IQR is $5.4 (P75 $12.0 minus P25 $6.6) and Cigna’s IQR is $9.2 (P75 $15.0 minus P25 $5.8), showing moderate spread; BUCA’s quartiles imply an IQR of $18.7 (P75 $45.2 minus P25 $26.5), reflecting higher-than-average commercial variability around its mean.