Cost analysis for CPT 87801 — Detection test by nucleic acid for multiple organisms, amplified probe(s) technique
Average Medicare Payment
$68.01
2023 data
Total Payments (2023)
$37.0M
Services (2023)
543.5K
Price Change (2014–2023)
-25.4%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $91.11 | $977.1K | 10.5K | — |
| 2015 | $90.82 | $1.3M | 13.6K | -0.3% |
| 2016 | $89.92 | $1.4M | 15.4K | -1.0% |
| 2017 | $88.49 | $4.8M | 53.5K | -1.6% |
| 2018 | $83.65 | $9.3M | 110.5K | -5.5% |
| 2019 | $75.46 | $20.6M | 271.9K | -9.8% |
| 2020 | $69.13 | $41.2M | 592.0K | -8.4% |
| 2021 | $69.45 | $46.1M | 661.9K | +0.5% |
| 2022 | $69.01 | $36.2M | 524.2K | -0.6% |
| 2023 | $68.01 | $37.0M | 543.5K | -1.4% |
The most expensive state pays 1.1x more than the cheapest for this procedure. WI averages $68.80 vs AL at $63.35.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| WI | $68.80 | $30.5K | 444 | 6 |
| RI | $68.80 | $58.8K | 855 | 6 |
| UT | $68.80 | $16.2K | 236 | 2 |
| TN | $68.80 | $18.2K | 264 | 1 |
| MO | $68.80 | $17.7K | 258 | 1 |
| DE | $68.80 | $7.2K | 105 | 1 |
| LA | $68.80 | $118.3K | 1.7K | 7 |
| WA | $68.77 | $78.0K | 1.1K | 2 |
| VA | $68.75 | $164.4K | 2.4K | 14 |
| CA | $68.75 | $1.5M | 21.8K | 30 |
| MA | $68.74 | $849.1K | 12.4K | 35 |
| PA | $68.73 | $786.9K | 11.4K | 26 |
| AR | $68.73 | $541.8K | 7.9K | 10 |
| OK | $68.73 | $3.1M | 45.3K | 21 |
| IL | $68.72 | $1.5M | 22.0K | 29 |
| MD | $68.71 | $833.7K | 12.1K | 24 |
| FL | $68.67 | $10.5M | 152.7K | 63 |
| NM | $68.64 | $77.7K | 1.1K | 5 |
| NJ | $68.63 | $1.6M | 23.6K | 23 |
| IA | $68.62 | $50.2K | 732 | 8 |
| NY | $68.57 | $1.8M | 26.3K | 24 |
| AZ | $68.50 | $96.4K | 1.4K | 8 |
| CO | $68.47 | $1.9M | 27.8K | 24 |
| MS | $68.40 | $891.5K | 13.0K | 30 |
| GA | $68.24 | $25.1K | 368 | 3 |
| KS | $68.18 | $71.0K | 1.0K | 6 |
| WV | $68.17 | $14.9K | 218 | 2 |
| MN | $67.69 | $22.1K | 327 | 7 |
| NC | $66.93 | $48.3K | 721 | 4 |
| NE | $66.54 | $26.3K | 396 | 5 |
| TX | $66.38 | $10.1M | 152.4K | 117 |
| MI | $63.43 | $34.9K | 550 | 5 |
| AL | $63.35 | $9.1K | 143 | 6 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Cap Diagnostics Llc | Clinical Laboratory | FL | $3.7M | 53.1K | $68.80 |
| Altru Diagnostics, Inc | Clinical Laboratory | TX | $3.1M | 45.7K | $68.79 |
| Laboratory Of Florida Llc | Clinical Laboratory | FL | $2.1M | 30.6K | $68.80 |
| Concord Life Sciences, Llc | Clinical Laboratory | TX | $1.7M | 29.4K | $57.20 |
| Bakotic Pathology Associates, Llc | Clinical Laboratory | FL | $1.6M | 22.6K | $68.78 |
| Rocky Mountain Laboratories Llc | Clinical Laboratory | CO | $1.4M | 20.4K | $68.76 |
| Riem Badr | Pathology | NY | $1.3M | 18.6K | $68.62 |
| Qitek Labs Of Oklahoma Llc | Clinical Laboratory | OK | $1.2M | 17.9K | $68.79 |
| Wellness Health Group, Llc | Clinical Laboratory | OK | $962.1K | 14.0K | $68.79 |
| Laboratory Corporation Of America Holdings | Clinical Laboratory | NJ | $642.9K | 9.4K | $68.64 |
| Samir Shirodkar | Urology | TX | $611.2K | 9.0K | $68.26 |
| Yousef Tadros | Pathology | IL | $562.1K | 8.2K | $68.80 |
| Ajay Kwatra | Urology | TX | $520.6K | 7.6K | $68.16 |
| Infinite Genomics Llc | Clinical Laboratory | AR | $435.4K | 6.3K | $68.78 |
| Quest Diagnostics Incorporated | Clinical Laboratory | NJ | $410.4K | 6.0K | $68.58 |
| Sea Level Labs Llc | Clinical Laboratory | FL | $403.0K | 5.9K | $68.76 |
| Advanced Biomedical, Inc. | Clinical Laboratory | CA | $403.0K | 5.9K | $68.78 |
| Wise Diagnostic Systems, Llc | Clinical Laboratory | TX | $370.4K | 5.4K | $68.58 |
| Southwest Regional Pcr, Llc | Clinical Laboratory | TX | $356.2K | 5.2K | $68.65 |
| Quest Diagnostics Massachusetts Llc | Clinical Laboratory | MA | $334.2K | 4.9K | $68.80 |
Based on the data, CPT 87801 shows a 1.1x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 25.4% 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.