CPT 87635: SARS‑CoV‑2 Amplified Nucleic Acid Detection
Commercial payers pay $58 on average nationally for this procedure.
CPT code 87635 describes a laboratory test that uses an amplified nucleic acid probe technique to detect nucleic acids from severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), the virus that causes COVID-19; service type: molecular diagnostic (nucleic acid amplification) testing; typical site of service: clinical laboratory or high‑complexity testing facility.
For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.
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National Reimbursement Benchmarks
BUCA’s average commercial rate of $57.9 for CPT 87635 sits near the center of the market, offering a useful baseline against which individual payer distributions diverge. Blue Cross Blue Shield’s interquartile spread (P75–P25) is $17.5, UnitedHealth Group’s spread is $20.5, and Aetna’s spread is $20.0; Cigna’s spread is the widest at $34.3. These differences indicate varying contract tightness around their medians and suggest more predictable payment bands for Blue Cross Blue Shield compared with Cigna.
In level terms, Aetna and Blue Cross Blue Shield have higher median or mean touchpoints than UnitedHealth Group and Cigna, while BUCA’s mean remains squarely mid-market. Cigna’s large P75–P25 gap of $34.3 reflects the greatest dispersion among the listed commercial payers, whereas Blue Cross Blue Shield’s $17.5 interquartile range is the tightest, implying more concentrated commercial rates for CPT 87635.