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Describe a service in plain words, or type a CPT/HCPCS code.

Group A Strep Molecular Test

CPT 87651

Ordered for a sore throat where strep is suspected, either as the first test or to check a negative rapid antigen result.

No national payment amount

Status X is not separately payable under the PFS.

Did Medicare pay separately for CPT 87651 in Q4 2025?

Not at a published national rate. CPT 87651 carries status X (statutory exclusion) in the Q4 2025 release. The statutory definition of physician services does not include this item. Treat the blank amount as unpriced, not as $0.

How often 87651 is billed

Across Original Medicare in CY2024, 87651 ranked #308 of the 7,879 CPT codes billed to Medicare that year, ranked by patients served or total allowed dollars.

Beneficiaries
494,115
Office + facility patients combined
Services
721,023
Times it was billed
Allowed
$24.7M
Total Medicare allowed dollars
Compare: ↑ #306 more popular · 27236 ↓ #309 less popular · 13121

2024 Medicare fee-for-service only, national totals — Medicare Advantage, Medicaid and commercial volume are excluded, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q4 2025 fee schedule the rates above come from.

Common questions

Why is there no payment amount for 87651?

Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. The blank is deliberate: the amount is either unknown or paid under another provision, so reading it as $0 would be wrong.

Why would a Medicare claim for 87651 be denied or paid less?

Each item below comes from a CMS indicator on this page — not general billing advice.

  • Its status indicator is X (statutory exclusion) — The statutory definition of physician services does not include this item. See status indicators

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Saw this code on your bill?

What is a 87651 visit in patient-friendly terms?

In plain terms: A molecular throat test for Streptococcus pyogenes, the bacterium behind strep throat. It amplifies the organism's genetic material, so it catches infections a rapid antigen test can miss, and a negative result is dependable enough that a backup throat culture is often unnecessary. Same swab as the front-desk rapid test, very different technology behind it. Think of a sore-throat visit where the swab goes to the lab for molecular testing and the answer arrives the same day, deciding whether antibiotics are appropriate. You'll typically see CPT 87651 on a bill or explanation of benefits (EOB) when a clinician performs or bills for this service.

Computation & policy

How this amount is computed

amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000. To price an RVU figure of your own, use the RVU-to-dollars converter.

Release Q4 2025

Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A blank means CMS publishes no national number for that part. Read it as unknown, and never as zero.

History & related

Rate history by release

National non-facility amount for 87651 across quarterly releases.

Release Status Non-facility Facility
Q3 2026 Jun 30, 2026 – present X
Q2 2026 Mar 10, 2026 – Jun 29, 2026 X
Q1 2026 Dec 29, 2025 – Mar 9, 2026 X

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Source & method

This is computed from CMS's Medicare Physician Fee Schedule Q4 2025 release (schedule pfs, effective October 2025). National amounts apply a GPCI of 1.000 and leave sequestration off. The status indicator decides payability, never the RVU values, so a blank RVU stays blank. Releases are immutable: a rate retrieved for a past quarter always reflects that release. Commercial and cash-pay figures anywhere on this page are arithmetic on the Medicare amount, using commonly cited reimbursement ranges. They're illustrative, and no nationwide claims database stands behind them.

Description written from primary sources: CMS Medicare Physician Fee Schedule Relative Value Files. Not derived from AMA CPT descriptor text.

Physician relative value file (Q4 2025) · 2025.zip (PPRRVU2025_Oct.csv row 10,864)

Conversion factor $32.3465 read from the same file, row 11, column 25.

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

This link keeps pointing at the Q4 2025 figures, even after a newer release lands.

CPT 87651 Medicare Physician Fee Schedule rate (Q4 2025). Localis. https://localishealth.com/cpt/87651/2025/D