CPT 87651: Streptococcus Group A by Amplified Nucleic Acid Probe
Commercial payers pay $75 on average nationally for this procedure.
CPT code 87651 describes a laboratory test that detects Streptococcus, group A using an amplified nucleic acid probe technique, typically performed as a molecular infectious agent detection service; service type: molecular diagnostic test for bacterial pharyngitis, typical site of service: clinical laboratory or outpatient clinic collection with laboratory processing.
For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.
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National Reimbursement Benchmarks
Commercial national averages for CPT 87651 center on a BUCA mean of $74.5, with individual payer means ranging from $36.2 to $99.7. Blue Cross Blue Shield posts the highest mean at $99.7 and a wide spread, while Aetna and Cigna sit closer to the BUCA average with means of $46.2 and $40.6 respectively. UnitedHealth Group’s mean of $36.2 is near the lower end of the commercial spectrum.
Dispersion measured as the interquartile range (P75–P25) is widest for Blue Cross Blue Shield at $34.2, reflecting greater variability in negotiated commercial rates. Aetna and Cigna show moderate dispersion at $31.0 and $26.5 respectively, while UnitedHealth Group is the tightest of the listed payers with an IQR of $19.8, indicating more consistent commercial pricing.