CPT 87636: SARS-CoV-2, Influenza A & B Multiplex Molecular Test
Commercial payers pay $154 on average nationally for this procedure.
CPT code 87636 describes a laboratory procedure in which a technical analyst performs multiplex amplified nucleic acid probe testing to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV‑2), influenza A, and influenza B; the service is a molecular infectious agent detection assay typically performed as a clinical laboratory service in hospital or reference laboratory settings.
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
National commercial rates for CPT 87636 cluster around BUCA’s average commercial benchmark of $154.30, with substantial differences among carriers. Blue Cross Blue Shield’s mean of $166.30 and Aetna’s mean of $151.40 sit near BUCA, while Cigna’s mean of $140.60 and UnitedHealth Group’s mean of $122.90 are lower. Maximums vary widely, from Aetna’s $345.20 and Blue Cross Blue Shield’s $324.50 to UnitedHealth Group’s $532.60 and Cigna’s $428.60, indicating occasional high outliers across payers.
Dispersion measured by the interquartile range (P75–P25) highlights where rates are tightest or widest: Blue Cross Blue Shield has the narrowest IQR at $49.70 ($182.50–$132.80), followed closely by Aetna at $13.20 ($155.20–$142.00), while UnitedHealth Group shows the widest spread at $76.10 ($142.80–$66.70). Cigna’s IQR is $95.40 and BUCA’s is $54.60, signaling that contractual variability is most pronounced with UnitedHealth Group and Cigna and relatively contained with Blue Cross Blue Shield and Aetna.