Cost analysis for CPT 87631 — Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets
Average Medicare Payment
$138.61
2023 data
Total Payments (2023)
$20.6M
Services (2023)
147.6K
Price Change (2014–2023)
-8.4%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $151.34 | $127.3K | 795 | — |
| 2015 | $152.93 | $159.9K | 1.0K | +1.1% |
| 2016 | $161.73 | $193.3K | 1.2K | +5.8% |
| 2017 | $158.46 | $544.7K | 3.3K | -2.0% |
| 2018 | $148.80 | $1.2M | 7.6K | -6.1% |
| 2019 | $138.59 | $2.6M | 18.6K | -6.9% |
| 2020 | $139.30 | $26.5M | 186.8K | +0.5% |
| 2021 | $140.17 | $26.9M | 189.4K | +0.6% |
| 2022 | $139.00 | $18.0M | 129.0K | -0.8% |
| 2023 | $138.61 | $20.6M | 147.6K | -0.3% |
The most expensive state pays 1.1x more than the cheapest for this procedure. KS averages $139.78 vs AL at $130.40.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| KS | $139.78 | $187.3K | 1.3K | 2 |
| MS | $139.78 | $159.3K | 1.1K | 7 |
| MA | $139.78 | $124.1K | 888 | 15 |
| NC | $139.78 | $120.6K | 863 | 8 |
| NV | $139.78 | $71.1K | 509 | 3 |
| MI | $139.78 | $65.7K | 470 | 10 |
| GA | $139.78 | $37.2K | 266 | 6 |
| WI | $139.78 | $28.7K | 205 | 5 |
| KY | $139.78 | $19.7K | 141 | 4 |
| SC | $139.78 | $16.1K | 115 | 2 |
| WY | $139.78 | $14.7K | 105 | 2 |
| IL | $139.73 | $668.9K | 4.8K | 28 |
| NY | $139.71 | $678.8K | 4.9K | 65 |
| AZ | $139.68 | $174.0K | 1.2K | 5 |
| PA | $139.67 | $1.1M | 7.9K | 27 |
| WA | $139.67 | $511.5K | 3.7K | 16 |
| MD | $139.65 | $127.6K | 914 | 11 |
| VA | $139.63 | $117.2K | 839 | 9 |
| TN | $139.62 | $24.3K | 174 | 3 |
| CO | $139.61 | $199.2K | 1.4K | 7 |
| TX | $139.53 | $8.5M | 60.7K | 94 |
| CA | $139.44 | $2.7M | 19.2K | 42 |
| DE | $139.42 | $54.7K | 392 | 8 |
| NJ | $139.39 | $2.1M | 15.4K | 45 |
| CT | $139.38 | $179.8K | 1.3K | 45 |
| IA | $139.27 | $38.3K | 275 | 8 |
| OK | $139.27 | $129.8K | 932 | 6 |
| AR | $139.23 | $106.5K | 765 | 18 |
| MN | $138.96 | $100.6K | 724 | 2 |
| FL | $138.86 | $1.4M | 10.2K | 59 |
| IN | $138.82 | $19.2K | 138 | 5 |
| NE | $138.65 | $30.9K | 223 | 9 |
| OH | $135.49 | $130.1K | 960 | 5 |
| LA | $135.08 | $163.6K | 1.2K | 13 |
| AL | $130.40 | $375.2K | 2.9K | 25 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Yellowstone Labs, Llc | Clinical Laboratory | TX | $3.0M | 21.7K | $139.78 |
| Healthtrackrx Indiana, Inc | Clinical Laboratory | TX | $1.7M | 12.2K | $139.47 |
| Texas Molecular Diagnostics Laboratory | Clinical Laboratory | TX | $745.0K | 5.3K | $139.75 |
| Tdm Laboratories Of Katy, Llc | Clinical Laboratory | TX | $739.6K | 5.3K | $139.78 |
| Quest Diagnostics Incorporated | Clinical Laboratory | NJ | $590.7K | 4.2K | $139.78 |
| American Premier Labs | Clinical Laboratory | TX | $470.8K | 3.4K | $139.78 |
| American Labworks Llc | Clinical Laboratory | WA | $446.7K | 3.2K | $139.78 |
| Silverpath, Inc. | Clinical Laboratory | PA | $430.6K | 3.1K | $139.77 |
| Accu Reference Medical Lab, Llc | Clinical Laboratory | NJ | $354.7K | 2.6K | $138.32 |
| Tekotest Lab Inc | Clinical Laboratory | CA | $335.9K | 2.4K | $139.78 |
| Rapid Dx Laboratory Llc | Clinical Laboratory | TX | $295.2K | 2.1K | $139.78 |
| Centers Lab Nj Llc | Clinical Laboratory | NJ | $284.2K | 2.0K | $139.19 |
| Nova Diagnostics Labs Llc | Clinical Laboratory | IL | $256.6K | 1.8K | $139.78 |
| Bryan Doonan | Family Practice | CA | $230.2K | 1.6K | $139.78 |
| Mohammad Qureshi | Pathology | NJ | $222.6K | 1.6K | $139.58 |
| Thousand Oaks Pathology Associates Inc | Clinical Laboratory | CA | $220.6K | 1.6K | $139.61 |
| Nbio Lab Inc | Clinical Laboratory | CA | $205.1K | 1.5K | $139.78 |
| Religen | Clinical Laboratory | PA | $185.2K | 1.3K | $139.78 |
| 4m Healthcare, Llc | Clinical Laboratory | KS | $184.2K | 1.3K | $139.78 |
| Quality Healthcare Management Inc | Clinical Laboratory | NY | $180.3K | 1.3K | $139.78 |
Based on the data, CPT 87631 shows a 1.1x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 8.4% since 2014. 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.