CPT 87631
Detection test by nucleic acid for multiple types of respiratory virus, multiple types or subtypes, 3-5 targets
Asking price, not received
The fee schedule figure
Balance is patient coinsurance
Providers submitted an average of $239.48 for this code and Medicare allowed $139.46 — 1.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $139.46 (100%); the rest is the patient’s coinsurance and deductible.
- Services
- 251,176
- Beneficiaries
- 204,254
- Providers billing it
- 778
- Total allowed
- $35,029,005
Medicare Part B, 2024
Services × allowed amount
What Medicare pays for CPT 87631
Across 251,176 services billed by 778 providers to 204,254 beneficiaries, Medicare allowed an average of $139.46 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.
Who bills 87631
| Specialty | Services | Beneficiaries | Avg allowed | Providers |
|---|---|---|---|---|
| Clinical Laboratory | 228,338 | 184,155 | $139.58 | 290 |
| Family Practice | 6,104 | 5,224 | $138.32 | 130 |
| Internal Medicine | 5,345 | 4,508 | $138.83 | 108 |
| Pathology | 3,715 | 3,597 | $138.73 | 11 |
| Nurse Practitioner | 3,437 | 3,207 | $135.50 | 125 |
| Physician Assistant | 1,877 | 1,808 | $138.58 | 74 |
| Independent Diagnostic Testing Facility (IDTF) | 963 | 462 | $139.65 | 1 |
| Emergency Medicine | 530 | 504 | $138.77 | 20 |
| Pulmonary Disease | 213 | 177 | $139.27 | 4 |
| Hematology-Oncology | 166 | 157 | $139.03 | 1 |
| Cardiology | 75 | 67 | $139.78 | 3 |
| Certified Clinical Nurse Specialist | 71 | 61 | $139.78 | 1 |
| Neurology | 70 | 65 | $139.78 | 1 |
| Nephrology | 64 | 64 | $139.78 | 2 |
| Sleep Medicine | 56 | 55 | $134.56 | 1 |
87631 reimbursement by state
Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.
| State | Services | Allowed | Standardized pmt | Providers |
|---|---|---|---|---|
| Texas | 99,577 | $139.64 | $139.78 | 115 |
| California | 38,283 | $139.61 | $139.78 | 67 |
| New Jersey | 18,143 | $139.45 | $139.78 | 52 |
| Arizona | 18,019 | $139.74 | $139.77 | 8 |
| Florida | 14,477 | $139.75 | $139.78 | 67 |
| Pennsylvania | 11,522 | $139.75 | $139.78 | 27 |
| Colorado | 11,056 | $139.76 | $139.78 | 11 |
| Illinois | 8,188 | $139.74 | $139.78 | 26 |
| Georgia | 8,082 | $139.72 | $139.78 | 10 |
| New York | 3,806 | $139.29 | $139.68 | 33 |
| Alabama | 2,719 | $132.03 | $139.38 | 63 |
| Arkansas | 2,233 | $139.05 | $139.78 | 47 |
| Mississippi | 1,956 | $139.32 | $139.78 | 39 |
| North Carolina | 1,320 | $139.78 | $139.78 | 10 |
| Oklahoma | 1,179 | $139.69 | $139.78 | 6 |
| Ohio | 1,061 | $139.41 | $139.78 | 6 |
| Virginia | 976 | $139.78 | $139.78 | 5 |
| Louisiana | 945 | $134.62 | $137.89 | 16 |
| Massachusetts | 900 | $139.61 | $139.78 | 22 |
| Connecticut | 883 | $139.52 | $139.78 | 30 |
| Michigan | 778 | $139.78 | $139.78 | 9 |
| Minnesota | 723 | $139.51 | $139.78 | 2 |
| Maryland | 660 | $110.09 | $139.78 | 6 |
| Tennessee | 598 | $139.55 | $139.78 | 14 |
| Nebraska | 356 | $139.39 | $139.78 | 15 |
| Wisconsin | 319 | $139.78 | $139.78 | 8 |
| Kentucky | 271 | $138.88 | $139.78 | 5 |
| Washington | 264 | $139.22 | $139.78 | 9 |
| Nevada | 260 | $139.78 | $139.78 | 3 |
| Iowa | 256 | $139.37 | $139.78 | 8 |
| Utah | 252 | $139.78 | $139.78 | 1 |
| Kansas | 222 | $139.78 | $139.78 | 9 |
| Indiana | 182 | $139.09 | $139.78 | 5 |
| West Virginia | 125 | $139.03 | $139.78 | 3 |
| Missouri | 118 | $139.78 | $139.78 | 4 |
| Wyoming | 100 | $139.78 | $139.78 | 2 |
| Oregon | 100 | $139.78 | $139.78 | 4 |
| South Carolina | 65 | $139.78 | $139.78 | 4 |
| Alaska | 61 | $137.80 | $139.78 | 1 |
| South Dakota | 49 | $139.78 | $139.78 | 1 |
| Delaware | 44 | $139.78 | $139.78 | 2 |
| Montana | 35 | $139.78 | $139.78 | 2 |
| Hawaii | 13 | $139.78 | $139.78 | 1 |
Related codes
- 87640Detection test by nucleic acid for staphylococcus aureus (bacteria)$34.35
- 87653Detection test by nucleic acid for strep (streptococcus$34.36
- 87635Amplifed dna or rna probe detection of severe acute respiratory syndro$50.11
- 87651Detection test by nucleic acid for strep (streptococcus$34.33
- 87641Detection test by nucleic acid for staphylococcus aureus$34.36
- 87637Detection test by multiplex amplified probe technique for severe acute$139.09
- 87624Detection test by nucleic acid for human papillomavirus (hpv)$34.30
- 87636Detection test by multiplex amplified probe technique for severe acute$138.39
- 87661Detection test by nucleic acid for trichomonas vaginalis (genital para$34.30
- 87634Detection test by nucleic acid for respiratory syncytial virus$68.72
- 87652Detection test by nucleic acid for strep (streptococcus$40.89
- 87625Detection test by nucleic acid for human papillomavirus (hpv)$39.71
Billing this code is not the same as earning it
An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.
What doctors are paid →·Look up a clinician →·All procedure codes →
Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.
How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.