Cost analysis for CPT 87635 — Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen
Average Medicare Payment
$49.88
2023 data
Total Payments (2023)
$46.7M
Services (2023)
931.7K
Price Change (2020–2023)
-1.8%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2020 | $50.79 | $21.1M | 416.7K | — |
| 2021 | $51.04 | $41.2M | 806.0K | +0.5% |
| 2022 | $50.35 | $44.4M | 879.8K | -1.4% |
| 2023 | $49.88 | $46.7M | 931.7K | -0.9% |
The most expensive state pays 1.0x more than the cheapest for this procedure. ME averages $50.28 vs MS at $49.53.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| ME | $50.28 | $49.4K | 983 | 4 |
| NH | $50.28 | $16.2K | 322 | 7 |
| VI | $50.28 | $11.5K | 229 | 6 |
| AE | $50.28 | $6.1K | 122 | 2 |
| CA | $50.25 | $12.1M | 241.7K | 938 |
| DE | $50.24 | $61.9K | 1.2K | 17 |
| IL | $50.22 | $3.8M | 75.0K | 468 |
| AZ | $50.22 | $646.8K | 12.9K | 53 |
| MD | $50.21 | $595.5K | 11.9K | 129 |
| NJ | $50.21 | $3.8M | 75.0K | 259 |
| NY | $50.20 | $5.7M | 112.6K | 724 |
| MA | $50.19 | $711.2K | 14.2K | 268 |
| DC | $50.19 | $40.4K | 806 | 17 |
| PR | $50.17 | $58.5K | 1.2K | 16 |
| PA | $50.16 | $1.1M | 22.5K | 331 |
| FL | $50.15 | $1.6M | 31.1K | 192 |
| TX | $50.15 | $2.2M | 44.4K | 415 |
| CO | $50.14 | $312.8K | 6.2K | 125 |
| VT | $50.13 | $15.0K | 300 | 15 |
| ID | $50.12 | $79.7K | 1.6K | 55 |
| UT | $50.12 | $129.8K | 2.6K | 45 |
| NV | $50.10 | $52.9K | 1.1K | 17 |
| MI | $50.10 | $461.4K | 9.2K | 201 |
| KS | $50.08 | $282.3K | 5.6K | 155 |
| MT | $50.07 | $88.7K | 1.8K | 55 |
| CT | $50.07 | $416.5K | 8.3K | 255 |
| VA | $50.07 | $511.9K | 10.2K | 219 |
| LA | $50.07 | $521.0K | 10.4K | 215 |
| WI | $50.05 | $263.4K | 5.3K | 28 |
| WY | $50.03 | $17.9K | 357 | 17 |
| MO | $50.03 | $670.5K | 13.4K | 232 |
| OK | $50.02 | $413.6K | 8.3K | 124 |
| RI | $50.01 | $26.3K | 526 | 10 |
| OH | $50.00 | $634.2K | 12.7K | 327 |
| IN | $50.00 | $515.6K | 10.3K | 273 |
| NC | $50.00 | $1.9M | 37.9K | 587 |
| NE | $49.96 | $140.4K | 2.8K | 76 |
| ND | $49.95 | $10.5K | 210 | 5 |
| IA | $49.94 | $235.7K | 4.7K | 127 |
| OR | $49.93 | $176.3K | 3.5K | 95 |
| AK | $49.89 | $61.4K | 1.2K | 36 |
| SD | $49.89 | $65.2K | 1.3K | 42 |
| WA | $49.86 | $369.2K | 7.4K | 229 |
| MN | $49.85 | $280.4K | 5.6K | 110 |
| AL | $49.85 | $809.3K | 16.2K | 311 |
| TN | $49.82 | $1.4M | 27.8K | 600 |
| HI | $49.82 | $181.0K | 3.6K | 38 |
| WV | $49.77 | $23.3K | 468 | 24 |
| AR | $49.76 | $322.7K | 6.5K | 159 |
| KY | $49.72 | $320.7K | 6.5K | 155 |
| GA | $49.70 | $891.4K | 17.9K | 483 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Fast Lab Technologies Llc | Clinical Laboratory | NY | $2.3M | 45.9K | $50.28 |
| Simple Laboratories Llc | Clinical Laboratory | IL | $1.2M | 24.6K | $50.26 |
| Genentox Laboratories Llc | Clinical Laboratory | CA | $983.5K | 19.6K | $50.28 |
| Prime Lab, Inc. | Clinical Laboratory | CA | $897.6K | 17.9K | $50.28 |
| Healthy Care Clinical Laboratory Inc | Clinical Laboratory | CA | $849.7K | 16.9K | $50.28 |
| Quest Diagnostics Incorporated | Clinical Laboratory | NJ | $808.8K | 16.1K | $50.28 |
| Laboratory Corporation Of America Holdings | Clinical Laboratory | NC | $769.3K | 15.3K | $50.16 |
| Shoreline Diagnostics Llc | Clinical Laboratory | CA | $750.6K | 14.9K | $50.28 |
| Healthtrackrx Indiana, Inc | Clinical Laboratory | TX | $667.6K | 13.3K | $50.17 |
| Laboratory Corporation Of America Holdings | Clinical Laboratory | NJ | $667.3K | 13.3K | $50.20 |
| Q Answer Lab Inc | Clinical Laboratory | NJ | $644.5K | 12.8K | $50.28 |
| Pacgenomics | Clinical Laboratory | CA | $581.3K | 11.6K | $50.28 |
| Pasteur Inc | Clinical Laboratory | CA | $446.1K | 8.9K | $50.28 |
| Biological Laboratory, Inc. | Clinical Laboratory | CA | $442.9K | 8.8K | $50.28 |
| Med Rush Clinical Lab Inc | Clinical Laboratory | IL | $434.6K | 8.6K | $50.28 |
| Cdr Laboratories Inc | Clinical Laboratory | FL | $378.5K | 7.5K | $50.28 |
| Acutis Diagnostics Inc | Clinical Laboratory | NY | $365.2K | 7.3K | $50.26 |
| Pathology Services Inc. | Clinical Laboratory | CA | $342.8K | 6.8K | $50.28 |
| Centers Lab Nj Llc | Clinical Laboratory | NJ | $274.4K | 5.5K | $50.27 |
| Avellino Lab Usa, Inc. | Clinical Laboratory | CA | $272.0K | 5.4K | $50.28 |
Based on the data, CPT 87635 shows a 1.0x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 1.8% 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.