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See a sample rate comparisonCPT 87635 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Sars Cov 2 Covid 19 Amp Prb, Infectious Agent Detection By Nucleic Acid Dna Or Rna Severe Acute Respiratory Syndrome Coronavirus 2 Sars Cov 2 Coronavirus Disease Covid 19 Amplified Probe Technique
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Microbiology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | None QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 87635 |
| Medicaid Fee Schedule | View Medicaid rates for 87635 |
National average reimbursement for CPT 87635 by major payers:
$55.10
$41.76
$61.16
$69.14
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CPT 87635
5 of 25 sample ratesHigher to lower in this preview
Temple Vamc
$51.31Published rateScott & White Memorial Hospital, Baylor Scott & White Medical Center - Temple
Scott & White Memorial Hospital
$51.31Published rateHomer Memorial Hospital, Claiborne Memorial Medical Center
Homer Memorial Hospital
$46.18Published rateWest Carroll Health Systems LLC, West Carroll Memorial Hospital
West Carroll Health Systems L.L.C.
$30.79Published rateCaldwell Memorial Hospital Inc
Caldwell Memorial Hospital, Inc.
$21.54Published rate
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See a sample payer proposalCPT 87635 vs. Other Microbiology Procedures Codes
The CPT 87635 code is part of the Pathology and Laboratory Procedures services used for Microbiology Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 87635 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 87631-CPT | Low | Resp Virus 3 5 Targets, Infectious Agent Detection By Nucleic Acid Dna Or Rna Respiratory Virus Eg Adenovirus Influenza Virus Coronavirus Metapneumovirus Parainfluenza Virus Respiratory Syncytial Virus Rhinovirus Includes Multiplex Reverse Transcription When Performed And Multiplex Amplified Probe Technique Multiple Types Or Subtypes 3 5 Targets |
| 87632-CPT | Low | Resp Virus 6 11 Targets, Infectious Agent Detection By Nucleic Acid Dna Or Rna Respiratory Virus Eg Adenovirus Influenza Virus Coronavirus Metapneumovirus Parainfluenza Virus Respiratory Syncytial Virus Rhinovirus Includes Multiplex Reverse Transcription When Performed And Multiplex Amplified Probe Technique Multiple Types Or Subtypes 6 11 Targets |
| 87633-CPT | Moderate | Infectious Agent Detection By Nucleic Acid (Dna Or Rna); Respiratory Virus (Eg Adenovirus Influenza Virus Coronavirus Metapneumovirus Parainfluenza Virus Respiratory Syncytial Virus Rhinovirus) Includes Multiplex Reverse Transcription When Performed And Multiplex Amplified Probe Technique Multiple Types Or Subtypes 12-25 Targets (Desc Revised 01/01/15) |
| 87635-CPT | Low | Sars Cov 2 Covid 19 Amp Prb, Infectious Agent Detection By Nucleic Acid Dna Or Rna Severe Acute Respiratory Syndrome Coronavirus 2 Sars Cov 2 Coronavirus Disease Covid 19 Amplified Probe Technique |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 87635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87635 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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