CPT 87804 Medicare payment status

Global period: what 87804's fee already covers Copy link

The global surgery concept does not apply to this code.

Check a pair of codes Copy link

Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit for the pair.

See every current NCCI pair for 87804 →

Payment review for 87804 Copy link

Rapid flu test payment depends on the method, how results are reported, the device, the units, and the lab fee source. Assuming two units or QW for every test makes the expected amount look precise while using the wrong inputs.

Sources: CMS Clinical Laboratory Fee Schedule; CMS Clinical Laboratory Improvement Amendments (CLIA); CMS Medicare NCCI Policy Manual (2026).

Rate history by release Copy link

National Office (non-facility) amount for 87804 across quarterly releases.

How often 87804 is billed Copy link

Across Original Medicare in CY2024, 87804 ranked #213 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 2.1 times on average that year.

2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, 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 Q3 2016 fee schedule above.

Who bills 87804 to Medicare

Observed CY2024 Medicare fee-for-service billing, by the rendering clinician's CMS specialty. Each share is that specialty's slice of all observed services for this code that year.

Setting split that year: 100% Office (non-facility) · 0% facility. CMS publishes only this facility vs non-facility split, never the exact place of service. The Office (non-facility) figure does not identify urgent care or any other specific setting.

CY2024 Medicare fee-for-service only, from the CMS Physician & Other Practitioners dataset, which suppresses rows under 11 beneficiaries. We omit specialty groups with fewer than 30 observed clinicians, so the shares can fall short of 100%. Specialty and practice-type pages linked elsewhere on this page are curated code lists, not utilization claims.

Related codes Copy link

Codes near 87804 in the pathology and laboratory services group, with their national Q3 2016 amounts at GPCI 1.000. A dash means the release publishes no payable PFS amount in that setting.

Localis groups these codes for payment research. The grouping isn't the AMA's code families.