Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#169 of 11K

87635

COVID-19 SARS-CoV-2 amplified probe detection

COVID-19 SARS-CoV-2 amplified probe detection is the #169 most-billed Medicaid procedure code, with $1.02B in payments across 25.9M claims from 2018–2024. The national median cost per claim is $39.70.

Total Paid

$1.02B

0.09% of all spending

Total Claims

25.9M

Providers

14K

Avg Cost/Claim

$39

National Cost Distribution

How much do providers bill per claim for 87635? Based on 13K providers billing this code nationally.

Median

$39.70

Average

$38.76

Std Dev

$36.92

Max

$908.19

Percentile Distribution (Cost per Claim)

p10
$8.43
p25
$26.04
Median
$39.70
p75
$48.87
p90
$51.32
p95
$61.07
p99
$105.13

50% of providers bill between $26.04 and $48.87 per claim for this code.

90% bill between $8.43 and $51.32.

Top 1% bill above $105.13.

About This Procedure

HCPCS code 87635 (COVID-19 SARS-CoV-2 amplified probe detection) was billed by 14K providers across 25.9M claims, totaling $1.02B in Medicaid payments from 2018–2024. This code was used for 22.4M unique beneficiaries.

Risk Assessment

This procedure is featured in our investigation: COVID Testing Boom

Read the full analysis for context on billing patterns associated with this code.

Billing Statistics

Median Cost/Claim

$39.70

Providers Billing

13K

National Spending

$1.02B

Avg/Median Ratio

0.98×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 87635

#ProviderTotal Paid
1Alaska Native Tribal Health Consortium

Anchorage, AK · General Acute Care Hospital

$64.6M
2Southeast Alaska Regional Health Consortium

Sitka, AK · Podiatrist

$17.8M
3Norton Sound Health Corporation

Nome, AK · General Acute Care Hospital, Critical Access

$10.4M
4Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$6.8M
51366499048$6.1M
6Healthtrackrx Indiana, Inc

Denton, TX · Clinical Medical Laboratory

$6.1M
7Tanana Chiefs Conference

Fairbanks, AK · Clinic/Center Multi-Specialty

$5.5M
81720029960$5.4M
91316995210$5.1M
10Texas Children's Hospital

Houston, TX · General Acute Care Hospital Children

$4.9M
11Optum Medical Care Of New Jersey Pc

Secaucus, NJ · Durable Medical Equipment & Medical Supplies

$4.7M
12Usa Biosciences Llc

Torrance, CA · Clinical Medical Laboratory

$4.6M
131396188074$4.6M
141710065933$4.2M
15County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$4.1M
16Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$4.0M
171871606269$3.8M
18New York Network Ipa Inc

Brooklyn, NY · Exclusive Provider Organization

$3.8M
19Northwell Health Laboratories

New Hyde Park, NY · Clinical Medical Laboratory

$3.6M
20Ochsner Clinic Foundation

New Orleans, LA · General Acute Care Hospital

$3.6M

Showing top 20 of 14K providers billing this code