CPT 87811: SARS–CoV–2 Antigen Immunoassay, Visual Read
Commercial payers pay $46 on average nationally for this procedure.
CPT code 87811 describes a laboratory immunoassay procedure for detection of SARS–CoV–2 (COVID-19) using direct optical (visual) observation, with the service performed by a lab analyst as the technical laboratory test; typical site of service is a clinical laboratory or point-of-care lab setting for diagnostic antigen testing of patient specimens.
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National Reimbursement Benchmarks
National commercial reimbursement for CPT 87811 centers on a BUCA average commercial rate of $46.10. Among individual payers, Blue Cross Blue Shield (BCBS) and Aetna have similar central tendencies near the BUCA mean, while Cigna and UnitedHealth Group show higher upper-end caps (Cigna max $121.60, UnitedHealth Group max $143.10) that pull their distributions wider. BUCA’s reported percentiles (P25 $35.00, P50 $45.10, P75 $51.80) place it squarely in the middle of the payer mix.
Examining dispersion (P75 minus P25) highlights variability: Blue Cross Blue Shield’s interquartile spread is $15.60 (P75 $53.60 minus P25 $38.00), Aetna’s spread is $9.00 (P75 $50.00 minus P25 $41.00), Cigna’s spread is $27.30 (P75 $50.60 minus P25 $24.30), UnitedHealth Group’s spread is $21.20 (P75 $47.90 minus P25 $27.70), and BUCA’s spread is $16.80. Aetna appears tightest and Cigna widest by this IQR comparison.