87426
SARS-CoV-2 COVID-19 antigen detection, immunoassay
SARS-CoV-2 COVID-19 antigen detection, immunoassay is the #217 most-billed Medicaid procedure code, with $707.8M in payments across 27.0M claims from 2018–2024. The national median cost per claim is $30.04.
Total Paid
$707.8M
0.06% of all spending
Total Claims
27.0M
Providers
14K
Avg Cost/Claim
$26
National Cost Distribution
How much do providers bill per claim for 87426? Based on 13K providers billing this code nationally.
Median
$30.04
Average
$28.20
Std Dev
$16.01
Max
$706.34
Percentile Distribution (Cost per Claim)
50% of providers bill between $20.36 and $35.84 per claim for this code.
90% bill between $7.95 and $42.14.
Top 1% bill above $55.00.
About This Procedure
HCPCS code 87426 (SARS-CoV-2 COVID-19 antigen detection, immunoassay) was billed by 14K providers across 27.0M claims, totaling $707.8M in Medicaid payments from 2018–2024. This code was used for 23.1M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$30.04
Providers Billing
13K
National Spending
$707.8M
Avg/Median Ratio
0.94×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 87426
| # | Provider | Total Paid |
|---|---|---|
| 1 | City Medical Of Upper East Side Pllc New York, NY · Clinic/Center Urgent Care | $18.5M |
| 2 | Topcare Medical Group Inc Dallas, TX · Pediatrics | $17.4M |
| 3 | Gentech Laboratories Llc Dallas, TX · Clinical Medical Laboratory | $11.9M |
| 4 | Bn Medicine Pc New York, NY · Clinic/Center, Primary Care | $10.1M |
| 5 | 1609066257 | $8.5M |
| 6 | 1053901256 | $7.9M |
| 7 | Fast Pace Medical Clinic Pllc Spring Hill, TN · Family Medicine | $6.8M |
| 8 | 1730337163 | $6.3M |
| 9 | 1669708780 | $6.3M |
| 10 | 1023379815 | $4.8M |
| 11 | Mnr Industries Llc Bel Air, MD · Clinic/Center Urgent Care | $4.1M |
| 12 | 1346608809 | $4.0M |
| 13 | 1699747303 | $3.1M |
| 14 | 1942623319 | $3.1M |
| 15 | 1912133315 | $2.8M |
| 16 | 1114948288 | $2.8M |
| 17 | Community Physicians Of Indiana Inc Indianapolis, IN · Internal Medicine | $2.6M |
| 18 | 1063436624 | $2.5M |
| 19 | 1982343315 | $2.4M |
| 20 | New York Network Ipa Inc Brooklyn, NY · Exclusive Provider Organization | $2.3M |
Showing top 20 of 14K providers billing this code