Cost analysis for CPT 87426 — Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus
Average Medicare Payment
$34.31
2023 data
Total Payments (2023)
$28.3M
Services (2023)
823.3K
Price Change (2020–2023)
-13.0%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2020 | $39.44 | $21.8M | 550.9K | — |
| 2021 | $39.06 | $66.5M | 1.7M | -1.0% |
| 2022 | $37.67 | $62.1M | 1.6M | -3.6% |
| 2023 | $34.31 | $28.3M | 823.3K | -8.9% |
The most expensive state pays 1.0x more than the cheapest for this procedure. VT averages $34.62 vs HI at $33.49.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| VT | $34.62 | $21.4K | 617 | 22 |
| PR | $34.60 | $158.7K | 4.6K | 107 |
| NC | $34.56 | $2.8M | 80.6K | 689 |
| PA | $34.54 | $551.0K | 16.0K | 403 |
| CT | $34.53 | $174.9K | 5.1K | 145 |
| CO | $34.52 | $69.0K | 2.0K | 75 |
| NH | $34.52 | $108.3K | 3.1K | 123 |
| IL | $34.52 | $870.2K | 25.2K | 359 |
| NJ | $34.50 | $1.7M | 48.7K | 833 |
| NY | $34.48 | $3.4M | 99.8K | 1.4K |
| ND | $34.47 | $14.0K | 406 | 16 |
| WV | $34.45 | $174.5K | 5.1K | 144 |
| TX | $34.45 | $2.5M | 72.3K | 1.9K |
| MO | $34.44 | $169.1K | 4.9K | 192 |
| FL | $34.43 | $2.1M | 60.5K | 1.3K |
| WI | $34.42 | $77.8K | 2.3K | 89 |
| WY | $34.41 | $45.9K | 1.3K | 37 |
| DC | $34.40 | $47.3K | 1.4K | 39 |
| MA | $34.40 | $364.9K | 10.6K | 307 |
| IA | $34.39 | $94.7K | 2.8K | 119 |
| MT | $34.39 | $29.4K | 856 | 38 |
| SD | $34.38 | $14.9K | 432 | 18 |
| SC | $34.37 | $594.5K | 17.3K | 409 |
| ME | $34.36 | $26.4K | 768 | 40 |
| MI | $34.36 | $584.2K | 17.0K | 377 |
| OH | $34.35 | $406.9K | 11.8K | 455 |
| MD | $34.35 | $1.1M | 30.9K | 709 |
| AR | $34.34 | $464.6K | 13.5K | 342 |
| DE | $34.33 | $68.3K | 2.0K | 67 |
| MN | $34.33 | $20.3K | 591 | 21 |
| ID | $34.33 | $10.8K | 315 | 16 |
| KS | $34.32 | $139.5K | 4.1K | 164 |
| IN | $34.32 | $436.3K | 12.7K | 399 |
| VA | $34.32 | $1.1M | 33.5K | 885 |
| CA | $34.31 | $1.5M | 43.3K | 833 |
| UT | $34.28 | $24.5K | 716 | 36 |
| GA | $34.28 | $1.3M | 39.2K | 798 |
| NE | $34.27 | $58.7K | 1.7K | 72 |
| RI | $34.26 | $87.6K | 2.6K | 58 |
| TN | $34.25 | $851.9K | 24.9K | 687 |
| NM | $34.23 | $195.2K | 5.7K | 101 |
| NV | $34.22 | $61.9K | 1.8K | 67 |
| MS | $34.19 | $907.4K | 26.5K | 567 |
| AZ | $34.18 | $257.4K | 7.5K | 289 |
| OK | $34.15 | $629.3K | 18.4K | 455 |
| WA | $34.13 | $119.5K | 3.5K | 120 |
| LA | $34.11 | $324.2K | 9.5K | 268 |
| AL | $34.07 | $672.0K | 19.7K | 426 |
| AK | $34.06 | $18.7K | 549 | 20 |
| OR | $33.99 | $103.3K | 3.0K | 118 |
| KY | $33.94 | $671.8K | 19.8K | 573 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Alpha Diagnostics, Llc | Clinical Laboratory | NC | $2.0M | 59.2K | $34.62 |
| Gentech Laboratories Llc | Clinical Laboratory | TX | $405.7K | 11.7K | $34.62 |
| Rm Medical Llc | Clinical Laboratory | IL | $256.4K | 7.4K | $34.62 |
| Hannan Lab Inc | Clinical Laboratory | IL | $222.4K | 6.4K | $34.62 |
| Mikhail Pinkhasov | Internal Medicine | NY | $189.7K | 5.5K | $34.62 |
| Medarbor Llc | Clinical Laboratory | PA | $188.2K | 5.4K | $34.62 |
| David Carmili | Pediatric Medicine | NY | $168.8K | 4.9K | $34.62 |
| Confucius Plaza Medical Laboratory Corp | Clinical Laboratory | NJ | $131.0K | 3.8K | $34.62 |
| Altia Landis | Nurse Practitioner | FL | $107.4K | 3.1K | $34.62 |
| Gmi Laboratories Llc | Clinical Laboratory | CA | $90.0K | 2.6K | $34.62 |
| Raymond Bedgood | Gastroenterology | GA | $56.1K | 1.6K | $34.37 |
| Envision Healthcare Resources, Llc | Clinical Laboratory | GA | $53.7K | 1.6K | $34.62 |
| Ryan Pickell | Internal Medicine | IN | $45.2K | 1.3K | $34.62 |
| Nobility Health, Inc. | Clinical Laboratory | CA | $42.1K | 1.2K | $34.62 |
| Wesley Thek | Emergency Medicine | NJ | $41.5K | 1.2K | $34.62 |
| Watson Clinic Llp | Clinical Laboratory | FL | $40.6K | 1.2K | $34.46 |
| Rakesh Soni | Family Practice | MI | $39.8K | 1.2K | $34.03 |
| Rami Georgies | Family Practice | CA | $36.9K | 1.1K | $34.59 |
| Victor Fariwa | Internal Medicine | NY | $36.8K | 1.1K | $34.62 |
| Laboratorio Clinico Borinquen, Inc | Clinical Laboratory | PR | $35.6K | 1.0K | $34.62 |
Based on the data, CPT 87426 shows a 1.0x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 13% since 2020. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.