Cost analysis for CPT 87636 — Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19) and influenza virus types a and b
Average Medicare Payment
$136.66
2023 data
Total Payments (2023)
$40.7M
Services (2023)
293.6K
Price Change (2020–2023)
-3.5%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2020 | $141.67 | $1.7M | 12.2K | — |
| 2021 | $140.44 | $11.1M | 78.2K | -0.9% |
| 2022 | $137.58 | $29.9M | 214.4K | -2.0% |
| 2023 | $136.66 | $40.7M | 293.6K | -0.7% |
The most expensive state pays 1.1x more than the cheapest for this procedure. MT averages $139.78 vs AZ at $124.87.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| MT | $139.78 | $47.0K | 336 | 17 |
| RI | $139.78 | $21.4K | 153 | 3 |
| SD | $139.78 | $14.4K | 103 | 6 |
| DE | $139.74 | $444.2K | 3.2K | 5 |
| NJ | $139.74 | $2.9M | 20.6K | 34 |
| IL | $139.73 | $5.8M | 41.2K | 115 |
| NY | $139.70 | $9.9M | 70.7K | 180 |
| WI | $139.67 | $86.9K | 622 | 7 |
| WY | $139.62 | $62.5K | 448 | 6 |
| CA | $139.59 | $6.1M | 44.0K | 87 |
| OK | $139.53 | $97.5K | 699 | 13 |
| ME | $139.46 | $52.4K | 376 | 2 |
| NV | $139.43 | $52.4K | 376 | 1 |
| HI | $139.40 | $39.5K | 283 | 4 |
| MO | $139.39 | $173.3K | 1.2K | 20 |
| OR | $139.35 | $27.9K | 200 | 5 |
| MA | $139.08 | $565.8K | 4.1K | 102 |
| MN | $139.08 | $54.8K | 394 | 8 |
| WV | $138.86 | $114.0K | 821 | 6 |
| AR | $138.82 | $269.4K | 1.9K | 57 |
| CO | $138.74 | $206.2K | 1.5K | 63 |
| LA | $138.65 | $297.3K | 2.1K | 55 |
| IN | $138.63 | $108.1K | 780 | 24 |
| CT | $138.57 | $290.3K | 2.1K | 62 |
| MS | $138.44 | $551.7K | 4.0K | 98 |
| PA | $138.39 | $418.6K | 3.0K | 21 |
| MI | $137.71 | $411.8K | 3.0K | 56 |
| KY | $137.68 | $1.1M | 8.1K | 196 |
| NM | $137.43 | $37.4K | 272 | 9 |
| NC | $137.40 | $640.3K | 4.7K | 89 |
| SC | $137.25 | $590.8K | 4.3K | 68 |
| TN | $137.08 | $1.3M | 9.8K | 223 |
| TX | $137.01 | $5.0M | 36.6K | 161 |
| OH | $136.64 | $428.1K | 3.1K | 38 |
| KS | $136.63 | $60.4K | 442 | 12 |
| ID | $136.50 | $16.2K | 119 | 5 |
| NH | $135.92 | $24.6K | 181 | 3 |
| FL | $135.74 | $493.4K | 3.6K | 49 |
| IA | $135.24 | $124.3K | 919 | 7 |
| VA | $134.46 | $190.1K | 1.4K | 29 |
| GA | $134.37 | $189.2K | 1.4K | 24 |
| WA | $134.06 | $578.5K | 4.3K | 103 |
| AL | $133.85 | $160.5K | 1.2K | 37 |
| MD | $130.44 | $259.8K | 2.0K | 43 |
| UT | $127.34 | $71.9K | 565 | 8 |
| AZ | $124.87 | $262.8K | 2.1K | 22 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Amedix | Clinical Laboratory | NY | $8.2M | 58.3K | $139.78 |
| Gentech Laboratories Llc | Clinical Laboratory | TX | $2.7M | 20.0K | $135.37 |
| Advanced Molecular Diagnostics, Llc | Clinical Laboratory | NJ | $2.1M | 14.9K | $139.78 |
| Clinical Laboratory Inc | Clinical Laboratory | IL | $2.0M | 14.0K | $139.78 |
| Gene By Gene Ltd | Clinical Laboratory | TX | $1.6M | 11.1K | $139.78 |
| Brio Clinical Inc | Clinical Laboratory | CA | $1.4M | 10.3K | $139.71 |
| Advanced Diagnostic Solutions Inc | Clinical Laboratory | IL | $807.2K | 5.8K | $139.78 |
| Hannan Lab Inc | Clinical Laboratory | IL | $742.4K | 5.3K | $139.78 |
| Arbor Vita Corporation | Clinical Laboratory | CA | $633.1K | 4.5K | $139.78 |
| Mmm Diagnostic Center Inc | Clinical Laboratory | IL | $629.7K | 4.5K | $139.78 |
| Sherman Abrams Laboratory Inc | Clinical Laboratory | NY | $605.5K | 4.3K | $139.78 |
| Strategic Concepts Lab Llc | Clinical Laboratory | CA | $506.7K | 3.6K | $139.78 |
| Delaware Diagnostic Labs, Llc | Clinical Laboratory | DE | $409.0K | 2.9K | $139.78 |
| Us Medical Labs Inc | Clinical Laboratory | IL | $367.9K | 2.6K | $139.78 |
| Medical Assay Laboratory | Clinical Laboratory | IL | $334.9K | 2.4K | $139.78 |
| Diagnostic Laboratory Science, Inc | Clinical Laboratory | CA | $311.3K | 2.2K | $139.78 |
| Genentox Laboratories Llc | Clinical Laboratory | CA | $295.2K | 2.1K | $139.65 |
| Newport Labs Inc | Clinical Laboratory | CA | $265.2K | 1.9K | $139.78 |
| Min Wu | Family Practice | CA | $249.2K | 1.8K | $139.78 |
| Quest Diagnostics Incorporated | Clinical Laboratory | NJ | $248.6K | 1.8K | $139.74 |
Based on the data, CPT 87636 shows a 1.1x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 3.5% 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.