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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 87631
  4. Cost Analysis

How Much Does Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets Cost on Medicare?

Cost analysis for CPT 87631 — Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets

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Average Medicare Payment

$138.61

2023 data

Total Payments (2023)

$20.6M

Services (2023)

147.6K

Price Change (2014–2023)

-8.4%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$151.34$127.3K795—
2015$152.93$159.9K1.0K+1.1%
2016$161.73$193.3K1.2K+5.8%
2017$158.46$544.7K3.3K-2.0%
2018$148.80$1.2M7.6K-6.1%
2019$138.59$2.6M18.6K-6.9%
2020$139.30$26.5M186.8K+0.5%
2021$140.17$26.9M189.4K+0.6%
2022$139.00$18.0M129.0K-0.8%
2023$138.61$20.6M147.6K-0.3%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.1x more than the cheapest for this procedure. KS averages $139.78 vs AL at $130.40.

StateAvg PaymentTotal PaymentsServicesProviders
KS$139.78$187.3K1.3K2
MS$139.78$159.3K1.1K7
MA$139.78$124.1K88815
NC$139.78$120.6K8638
NV$139.78$71.1K5093
MI$139.78$65.7K47010
GA$139.78$37.2K2666
WI$139.78$28.7K2055
KY$139.78$19.7K1414
SC$139.78$16.1K1152
WY$139.78$14.7K1052
IL$139.73$668.9K4.8K28
NY$139.71$678.8K4.9K65
AZ$139.68$174.0K1.2K5
PA$139.67$1.1M7.9K27
WA$139.67$511.5K3.7K16
MD$139.65$127.6K91411
VA$139.63$117.2K8399
TN$139.62$24.3K1743
CO$139.61$199.2K1.4K7
TX$139.53$8.5M60.7K94
CA$139.44$2.7M19.2K42
DE$139.42$54.7K3928
NJ$139.39$2.1M15.4K45
CT$139.38$179.8K1.3K45
IA$139.27$38.3K2758
OK$139.27$129.8K9326
AR$139.23$106.5K76518
MN$138.96$100.6K7242
FL$138.86$1.4M10.2K59
IN$138.82$19.2K1385
NE$138.65$30.9K2239
OH$135.49$130.1K9605
LA$135.08$163.6K1.2K13
AL$130.40$375.2K2.9K25

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Yellowstone Labs, LlcClinical LaboratoryTX$3.0M21.7K$139.78
Healthtrackrx Indiana, IncClinical LaboratoryTX$1.7M12.2K$139.47
Texas Molecular Diagnostics LaboratoryClinical LaboratoryTX$745.0K5.3K$139.75
Tdm Laboratories Of Katy, LlcClinical LaboratoryTX$739.6K5.3K$139.78
Quest Diagnostics IncorporatedClinical LaboratoryNJ$590.7K4.2K$139.78
American Premier LabsClinical LaboratoryTX$470.8K3.4K$139.78
American Labworks LlcClinical LaboratoryWA$446.7K3.2K$139.78
Silverpath, Inc.Clinical LaboratoryPA$430.6K3.1K$139.77
Accu Reference Medical Lab, LlcClinical LaboratoryNJ$354.7K2.6K$138.32
Tekotest Lab IncClinical LaboratoryCA$335.9K2.4K$139.78
Rapid Dx Laboratory LlcClinical LaboratoryTX$295.2K2.1K$139.78
Centers Lab Nj LlcClinical LaboratoryNJ$284.2K2.0K$139.19
Nova Diagnostics Labs LlcClinical LaboratoryIL$256.6K1.8K$139.78
Bryan DoonanFamily PracticeCA$230.2K1.6K$139.78
Mohammad QureshiPathologyNJ$222.6K1.6K$139.58
Thousand Oaks Pathology Associates IncClinical LaboratoryCA$220.6K1.6K$139.61
Nbio Lab IncClinical LaboratoryCA$205.1K1.5K$139.78
ReligenClinical LaboratoryPA$185.2K1.3K$139.78
4m Healthcare, LlcClinical LaboratoryKS$184.2K1.3K$139.78
Quality Healthcare Management IncClinical LaboratoryNY$180.3K1.3K$139.78

🤔 Is Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets Overpriced?

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.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.