What's a little above avg? If by avg you mean 217 and a little above you mean 225 and by top programs you mean MGH/UCSF/etc, then the answer is as always it depends.
Did you do well on your shelf exams? Do you feel confident about your clinical knowledge? Is the rest of your application above average?
Unlike other fields I don't think USMLE counts as much. Even top places seem to suggest that if you get an 85 they'll consider you (maybe not offer an interview, but they'll consider you!).