Surgical · Multi-region

87070

Aerobic bacterial culture of a specimen other than blood, urine, or stool, such as joint fluid or a wound swab, including presumptive identification.

3 sources ↓

Medicare
$0.00
Work RVU
0
Global, days
Region
Multi-region
Drawn from CMS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 3 cited references ↓

  • Specimen source and site, such as right knee synovial fluid
  • Number of separate specimens sent
  • Clinical findings suggesting infection
  • Antibiotic exposure before the sample was taken
  • Diagnosis code for suspected septic arthritis, osteomyelitis, or wound infection

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 ↓

87070 is the aerobic bacterial culture for sources other than blood, stool, or urine. In orthopedics that means joint aspirate, wound swabs, bursal fluid, and tissue sent from the OR. It includes presumptive identification of what grows.

The classic case: a swollen, warm knee is aspirated in clinic. Fluid goes for cell count, crystals, Gram stain, and culture. The aspiration (20610 or 20611) is billed by the practice. The culture is billed by the lab. If your practice runs its own CLIA-certified lab, you can bill the culture yourself, but most do not.

Definitive identification of each isolate beyond the presumptive level is reported with 87077, and susceptibility testing with 87184 or 87186. Anaerobic culture is a separate code (87075). Denials usually come from missing infection-related diagnoses or from billing identification that the payer views as already included. During revision arthroplasty, multiple tissue samples are standard, and each specimen sent separately can be its own unit when the lab reports them separately.

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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$0.00

Common denial reasons

The recurring reasons claims for CPT 87070 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

  • Multiple specimens billed without a modifier showing separate sources
  • Billed with a blood, urine, or stool source
  • Definitive identification billed when only presumptive work was done
  • Diagnosis code does not indicate suspected infection
  • Billed by the ordering practice without lab certification

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 3 cited references ↓

01What CPT code is used for a joint fluid culture?
Aerobic culture of joint fluid is reported with 87070. Anaerobic culture, if also run, is 87075.
02Can I bill 87070 for each tissue sample sent during revision surgery?
When the lab cultures and reports each specimen separately, each can be a unit. Use a distinct-site modifier where the payer requires it.
03Does 87070 include susceptibility testing?
No. Susceptibility is billed separately with 87184 or 87186 when the lab performs it.

Sources & references

Editorial content was developed using the following public sources.

  1. 01CMS Physician Fee Schedule 2026
  2. 02CMS Clinical Laboratory Fee Schedule 2026
  3. 03
    cms.gov
    https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits

Mira Scribe

Mira Scribe notes the aspiration site, fluid appearance, and the provider's infection concern during the visit, so the culture order has a specific source and reason.

See how Mira captures CPT 87070 documentation

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