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#413 of 11K

87428

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each

SARS-CoV-2 COVID-19 antigen detection, immunoassay, each is the #413 most-billed Medicaid procedure code, with $253.3M in payments across 6.6M claims from 2018–2024. The national median cost per claim is $39.63.

Total Paid

$253.3M

0.02% of all spending

Total Claims

6.6M

Providers

6K

Avg Cost/Claim

$38

National Cost Distribution

How much do providers bill per claim for 87428? Based on 5K providers billing this code nationally.

Median

$39.63

Average

$40.81

Std Dev

$21.82

Max

$199.37

Percentile Distribution (Cost per Claim)

p10
$12.59
p25
$26.19
Median
$39.63
p75
$57.36
p90
$63.59
p95
$69.78
p99
$96.02

50% of providers bill between $26.19 and $57.36 per claim for this code.

90% bill between $12.59 and $63.59.

Top 1% bill above $96.02.

About This Procedure

HCPCS code 87428 (SARS-CoV-2 COVID-19 antigen detection, immunoassay, each) was billed by 6K providers across 6.6M claims, totaling $253.3M in Medicaid payments from 2018–2024. This code was used for 5.9M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$39.63

Providers Billing

5K

National Spending

$253.3M

Avg/Median Ratio

1.03×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87428

#ProviderTotal Paid
1Fast Pace Medical Clinic Pllc

Spring Hill, TN · Family Medicine

$12.8M
21457716706$3.0M
31447769559$2.8M
4Our Lady Of The Lake Hospital Inc.

Baton Rouge, LA · General Acute Care Hospital

$2.8M
51467715490$2.7M
61427441286$2.6M
71306873500$2.6M
81689603748$2.5M
91053548487$2.1M
101679578439$2.1M
111366425274$1.9M
12State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$1.7M
131427125269$1.7M
141730193244$1.7M
151770587149$1.5M
161134172000$1.5M
171124092036$1.5M
181588663769$1.4M
191609192319$1.3M
20City Medical Of Upper East Side Pllc

New York, NY · Clinic/Center Urgent Care

$1.2M

Showing top 20 of 6K providers billing this code