CPT 87428: SARS Coronavirus and Influenza Antigen Immunoassay
Commercial payers pay $60 on average nationally for this procedure.
CPT code 87428 describes a laboratory immunoassay performed to qualitatively or semiquantitatively detect and differentiate antigens from severe acute respiratory syndrome coronaviruses (including SARS–CoV–2) and influenza A and B from a patient respiratory specimen; service type: infectious agent antigen detection by immunoassay (qualitative/semiquantitative); typical site of service: clinical laboratory or hospital laboratory processing respiratory specimens for diagnostic evaluation of acute viral respiratory illness.
Customize your policy alerts
Sign up for cpt 87428 policy alerts
Get alerted when payer policies referencing 87428 are released or updated.
Monitor payer policy activity
National Reimbursement Benchmarks
National commercial rates for CPT 87428 center around BUCA’s average commercial rate of $59.90, with individual payer medians and means varying notably. Blue Cross Blue Shield’s interquartile span is moderate at $20.70 (P75 $65.20 minus P25 $43.50), while Aetna shows a tighter middle spread of $14.00 (P75 $84.40 minus P25 $73.00). Cigna’s IQR is wide at $70.00 (P75 $81.60 minus P25 $11.80), and UnitedHealth Group has a sizable spread of $40.10 (P75 $73.50 minus P25 $34.40). BUCA’s commercial IQR is $27.60 (P75 $71.50 minus P25 $41.90).
Dispersion indicates variability in negotiated rates: Aetna displays the tightest middle distribution, suggesting more consistency around its central values, while Cigna has the widest interquartile range, reflecting greater variability across contracts. UnitedHealth Group and BUCA sit between these extremes, and Blue Cross Blue Shield shows moderate dispersion.