Culture used only to screen for one or more specific pathogens, such as MRSA or staph aureus carriage, without full identification of everything that grows.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Planned surgery and date
- Target organism being screened
- Specimen site, usually anterior nares
- Decolonization plan if the result is positive
- Pre-procedural and surgical diagnosis codes
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
87081 is a screening culture for a targeted organism. The lab plates the specimen on selective media and reports whether the target organism is present. It does not identify everything that grows.
The common orthopedic use is pre-operative MRSA and staph aureus nasal screening before total joint or spine surgery. Positive patients get decolonization with nasal mupirocin and chlorhexidine washes, and some programs change the prophylactic antibiotic. Many hospitals now screen with PCR instead, which uses a molecular code (87641 for MRSA), so confirm the method on the lab report.
Some payers treat pre-op screening as part of the surgical package or as a hospital quality measure and will not pay it as a separate lab. Check the contract. When it is paid, the lab bills it under the Clinical Laboratory Fee Schedule. Linking the order to the planned procedure, with a Z01.81- pre-procedural exam code plus the surgical diagnosis, is the usual approach.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
Common denial reasons
The recurring reasons claims for CPT 87081 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Payer bundles pre-op screening into the surgical or facility payment
- Lab ran PCR and the culture code was billed
- Diagnosis lacks a pre-procedural or surgical link
- Duplicate screening already done at the hospital
- Billed by the ordering office instead of the lab
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What CPT code is used for a pre-op MRSA nasal swab?
02Is pre-operative MRSA screening covered?
03Can 87081 be billed more than once?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02CMS Clinical Laboratory Fee Schedule 2026
- 03cms.govhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits
Mira Scribe
Mira Scribe captures the surgical plan and pre-op orders discussed at the visit, so a screening culture is clearly tied to the scheduled procedure.
See how Mira captures CPT 87081 documentation