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See a sample rate comparisonCPT 87636 Fee Schedule
Medicare rates as of January 2026
CPT 87636 is classified under Pathology and Laboratory Procedures, in the Microbiology Procedures subgroup.
Sarscov2 Inf A B Amp Prb, Infectious Agent Detection By Nucleic Acid Dna Or Rna Severe Acute Respiratory Syndrome Coronavirus 2 Sars Cov 2 Coronavirus Disease Covid 19 And Influenza Virus Types A And B Multiplex 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 | QW - CLIA Waived Tests 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $142.63 national lab fee schedule rate (2026) · View Medicare rates for 87636 |
| Medicaid Fee Schedule | $131.215 median of the 8 states in the free preview · View Medicaid rates for 87636 |
National average reimbursement for CPT 87636 by major payers:
$120.63
BCBS / Anthem
$95.82
UnitedHealthcare
$161.96
Aetna
$185.16
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 87636.
CPT 87636
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$416.06Published rateRobert Rubino
Atlantic Health System Inc
$145.47Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Spartanburg
Prisma Health - Upstate
$128.36Published rateNevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
$72.92Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$49.91Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 87636 vs. Other Microbiology Procedures Codes
The table lists codes related to 87636. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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) |
| 87634-CPT | Low | Infectious Agent Detection By, Infectious Agent Detection By Nucleic Acid (Dna Orrna) Respiratory Syncytial Virus Amplified Prob E Technique Cancer Detection On Repeat Biopsy Hpa-9ab (V837m) |
| 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 |
| 87636-CPT | Low | Sarscov2 Inf A B Amp Prb, Infectious Agent Detection By Nucleic Acid Dna Or Rna Severe Acute Respiratory Syndrome Coronavirus 2 Sars Cov 2 Coronavirus Disease Covid 19 And Influenza Virus Types A And B Multiplex 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 87636. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 87636 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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Frequently Asked Questions
The cost of a medical procedure can vary widely based on the provider, your insurance plan, and your geographical location. To get an estimate, you can contact your healthcare provider directly or your insurance company. For a more precise understanding of prices for specific CPT codes in your area, you can use tools like Payerprice.
CPT stands for Current Procedural Terminology. CPT codes are standardized numerical codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are crucial for accurate billing and for your insurance company to process claims effectively. Understanding the CPT code for a service helps you research its cost.
For accurate pricing information for specific CPT codes based on your location, it's best to use a specialized tool. We recommend Payerprice, which offers a fee schedule lookup tool where you can search with a CPT code and your specific location to find relevant pricing data.
Typically, no. Most insurance plans have deductibles, copayments, and coinsurance that you are responsible for paying before your insurance covers the remaining costs. Additionally, certain services might not be covered at all, or only partially, depending on your plan's benefits. Always review your specific insurance policy and contact your provider for details.
The billed amount is the total charge for a service that a healthcare provider submits to your insurance company. The negotiated rate (also known as the allowed amount or contracted rate) is the discounted price that your insurance company has agreed upon with the provider for that service. You are typically responsible for your share (deductible, copay, coinsurance) of the negotiated rate, not necessarily the full billed amount.