CPT 87045: Aerobic Bacterial Stool Culture for Salmonella/Shigella
Commercial payers pay $30 on average nationally for this procedure.
CPT code 87045 describes an aerobic bacterial stool culture in which the laboratory analyst inoculates selective media, isolates potential bacterial pathogens, and performs a preliminary examination to identify the presence of Salmonella or Shigella species; the service is a microbiology culture and identification procedure typically performed in a clinical laboratory setting (hospital or outpatient lab) on stool specimens from patients with suspected infectious gastroenteritis or diarrheal illness.
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National Reimbursement Benchmarks
National commercial reimbursement for CPT 87045 centers around BUCA’s average commercial benchmark of $30.00, with individual commercial payers showing meaningful differences in central tendency. Blue Cross Blue Shield’s median sits notably higher than most peers at $37.30, while Cigna and Aetna present medians near $8.50 and $7.70 respectively; UnitedHealth Group’s median of $5.70 is on the lower end. These medians indicate that BUCA’s average aligns closer to mid-to-upper commercial levels rather than the lower medians seen with some national insurers.
Dispersion (P75 minus P25) highlights payer variability: Blue Cross Blue Shield has the widest interquartile spread at $18.30 (P75 $52.00 minus P25 $33.70), indicating greater variability in contracted rates, while UnitedHealth Group is the tightest with a spread of $5.20 (P75 $9.40 minus P25 $4.20). Cigna and Aetna show moderate spreads of $8.30 and $4.00 respectively, and BUCA’s interquartile spread is $10.90 (P75 $34.40 minus P25 $21.50), placing it in the middle of the dispersion range.