CPT 87880: Streptococcus Group A Rapid Immunoassay (Visual)
Commercial payers pay $27 on average nationally for this procedure.
CPT code 87880 describes an immunoassay with direct optical (visual) observation to detect Streptococcus, group A—a point-of-care rapid strep test typically performed on a throat swab; the service is a diagnostic antigen detection test usually rendered in physician offices, urgent care clinics, and outpatient clinic laboratories and is used to confirm streptococcal pharyngitis in patients presenting with sore throat symptoms.
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
Across national commercial payers, BUCA’s average commercial rate of $27 serves as a mid-market reference point while individual payer means vary: Aetna $22.4, Blue Cross Blue Shield $33.6, Cigna $15.9, and UnitedHealth Group $16.1. Blue Cross Blue Shield shows the highest mean and widest absolute spread in upper-to-lower quartiles, indicating broader negotiated outcomes around that higher central tendency. Cigna and UnitedHealth Group sit below BUCA’s mean, with Cigna’s lower quartile concentration suggesting more skew toward modest rates.
Comparing dispersion (P75 minus P25) highlights which payers are tightest or widest: Aetna’s interquartile spread is $15.0, Blue Cross Blue Shield’s is $13.7, BUCA’s is $12.5, Cigna’s is $12.5, and UnitedHealth Group’s is $6.0, making UnitedHealth Group the tightest and Aetna the widest by this measure. Maximums and minimums where available further underline that Blue Cross Blue Shield reaches the highest ceiling ($108.8) while Aetna and Cigna show lower floor points ($4.2 and $5.0 respectively).