| Category | Amount |
|---|---|
| Medicare Allowed Rate What Medicare approves for this service | $16.55 |
| Typical Billed Amount What providers commonly charge | $25 – $100 |
| Potential Markup How much more you might pay vs. Medicare rate | 504% above Medicare |
What CPT 87880 Means and When It's Used
CPT code 87880 represents a rapid strep test, officially called "Infectious agent detection, streptococcus group A, direct optical." This is the quick test your doctor performs when you have a sore throat to check for strep bacteria.
Your healthcare provider will use this test when you have symptoms like severe sore throat, difficulty swallowing, fever, or swollen lymph nodes. The test involves swabbing your throat and getting results within 5-10 minutes, which is much faster than sending a culture to the lab.
This code falls under the lab-pathology category, meaning it's considered laboratory work even though it's often done right in your doctor's office. The test helps determine whether your sore throat is caused by strep bacteria (which needs antibiotics) or a virus (which doesn't).
How Billing Works for Rapid Strep Tests
When you see CPT code 87880 on your medical bill, you can expect charges to range from $25 to $100, depending on your healthcare provider and location. Medicare reimburses this test at $16.55, which gives you an idea of the actual cost of performing the test.
The charge may appear on your bill as "lab services," "diagnostic testing," or simply "strep test." Some insurance plans cover this test completely when it's medically necessary, while others may require you to pay a copay or meet your deductible first.
If you have a high-deductible health plan, you might be responsible for the full charge until you meet your deductible. However, many urgent care centers and clinics offer cash prices that are often lower than what they bill insurance companies.
How to Verify Your Rapid Strep Test Charges
To check if you were billed correctly for CPT code 87880, first confirm that you actually received a rapid strep test during your visit. Look for the code on your Explanation of Benefits (EOB) from your insurance company, not just your provider's bill.
If the charge seems unusually high (over $100), contact your healthcare provider's billing department to ask for an itemized explanation. Sometimes, additional charges for office visits or other services can make the total seem higher than expected.
If you believe you were overcharged, you can request a payment plan, ask about financial assistance programs, or negotiate a lower cash price. Many providers are willing to work with patients, especially if you're paying out of pocket.